Laparoscope Assisted Extracorporeal Appendectomy Versus Conventional Open Appendectomy: a Prospective Study

To evaluate the usefulness of laparoscopy assisted extracorporeal appendicectomy versus conventional open appendicectomy in terms of intraoperative complication, duration of hospital stay, wound infection and morbidity.

The prospective study was carried out in the department of surgery, LLRM Medical College and associated SVBP hospital Meerut, India from June 2010 to December 2010 after taking permission from ethical committee. 63 patients of age ranging from 10–60 years with features of acute appendicitis were divided between LAEA group and open appendicectomy group.

Peak incidence of appendicitis in our study was in 2^nd decade (39.68%) followed by 3^rd decade (39.42%). Out of 63 appendicectomies performed 46 were open and 17 LAEA. Majority of the patients who underwent LAEA developed pain (47.05%) and vomiting (47.05%) followed by fever (29.41%) and constipation (10.76%) and paralytic ileus (5.88%) postoperatively after successful procedure with mean complication rate of 28.03% (SD 2.22). In open cases more patients experienced pain (89.13%), fever (17.69%), vomiting (47.82%), constipation (28.08%) and ileus 28.26% wound infection occurring in 21.73% of cases with mean complication rate of 43.16% (SD 1.99) but almost similar incidence of vomiting in post operative period.

This study reveals that LAEA is better in terms of post operative complications and lesser number of doses were required of analgesic, antipyretic and antiemetic drugs. Return to normal activity and tolerance to regular diet is also earlier in patients operated for LAEA.