Abstract

LAPAROSCOPIC VERSES OPEN APPENDISECTOMY, A PROSPECTIVE RANDOMIZED CONTROL STUDY ASSESSING OUTCOME AND COST BENEFIT.

Dr. Sadanand Balkrushna Joshi*, Dr. Kunal Sadanand Joshi, Dr. Asha Sadanand Joshi, Dr. Kanchan Kunal Joshi

Abstract

Background: Appendectomy is the most common surgical procedure performed in emergency surgery. Because of lack of consensus about the most appropriate technique, appendectomy is still being performed by both open and laparoscopic methods. In this prospective analysis, we aimed to compare the laparoscopic approach and the conventional technique in the treatment of acute appendicitis. Methods: A randomised prospective study done for a period of 2 years from 1st June 2015 to 31st May 2017; Department of Surgery, Anand Hospital Islampur. 200 patients were randomly divided into 2 groups, one undergoing Open Appendisectomy and the other undergoing Laparoscopic Appendisectomy, with each group comprising 100 patients. Duration of surgery, postoperative complications, postoperative hospital stay, postoperative pain and requirement of analgesia, resumption of oral feeds, cost of hospital stay and return to normal activities was compared and noted. Result: Laparoscopic appendisectomy was better than open appendisectomy with respect to the wound infection rate, early resumption of oral feeds, postoperative pain, lesser use of analgesics, postoperative hospital stay (3.13 days after LA, 4.36 days after OA, P < 0.0001) and return to normal activities (LA group to OA group; 13.86 days to 19.44 days P< 0.0001). Although above mentioned advantages were at the cost of slightly increased duration of surgery (58.29 min in OA group to 74.13 min in LA group P < 0.000) and cost of surgery {LA: OA Rs.4225.81: Rs.5560.92 (P

Keywords: Appendisectomy, Laparoscopic, Surgery.