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Article Type

Article

Abstract

Background: Complicated appendicitis is characterized as perforation, necrotic change, periappendicular phlegmon or definite abscess which does not necessitate same-day surgery anymore. But if it does, that's a big gamble. Mortality in non-complicated non-gangrenous appendicitis is < 0.1%, gangrenous appendicitis 0.6% and perforation of appendic > 5%. The only effective treatment is an appendectomy, either open or laparascopic. For the past two decades laparoscopy has been advocated as an alternative to standard surgery yet there is controversy and a lack of consensus about its usefulness in more severe conditions.
Objective: To compare open and laparoscopic appendectomy for difficult acute appendicitis in terms of operative time, wound infection, post surgical sepsis, ileus, time to first oral intake, hospital stay and time to return to routine activities.
Patients and Methods: In a prospective randomized controlled trial, 50 patients with severe acute appendicitis were randomized into Group A (open appendectomy n = 25) and Group B (laparoscopic appendectomy n = 25) to evaluate the above specified outcomes.
Results: The prolonged time of laparoscopy (about 30 minutes more than open surgery) was beneficial in the postoperative period with fewer wound infections, absence of postoperative ileus and early return to regular daily activities. The time to start oral intake and the total duration of hospital stay were similar in the 2 groups.
Conclusion: Laparoscopic appendicectomy is safe and effective in severe acute appendicitis with improved outcome despite longer time in theater compared to open operation.

Keywords

Laparoscopic appendectomy, Complicated appendicitis

Creative Commons License

Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.

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