A COMPARATIVE STUDY OF LAPAROSCOPIC APPENDICECTOMY VERSUS OPEN APPENDICECTOMY IN TERMS OF DURATION OF SURGERY,LENGTH OF HOSPITAL STAY,RESUMPTION OF DIET, POST OPERATIVE COMPLICATIONS IN THANJAVUR MEDICAL COLLEGE A PROSPECTIVE STUDY

Abstract

Introduction: Appendicitis is most common intra abdominal condition requiring emergency surgery. The life time rate of appendicectomy is 12% for men and 25% in women, with approximately 7% of all people undergoing appendicectomy for acute appendicitis during their lifetime. Laparoscopic appendicectomy combines the advantages of treatment and diagnosis in one procedure with the least morbidity3. Patients are likely to have less post operative pain and to be discharged from hospital and return to regular activities quicker than those who underwent an open appendicectomy Methodology: Patients admitted in surgical wards, with clinical diagnosis of acute or recurrent appendicitis for a period of one year. The following parameters were observed between the two procedures. Duration of procedure ,Postoperative pain,Duration of surgery in minutes, Postoperative complications and wound infection, Post operative length of hospital stay in number of days, Resumption of diet. Results: The gold standard treatment for acute appendicitis is appendicectomy. Though open appendicectomy remains gold standard, nowadays laparoscopic appendicectomy has gained a lot of importance now. Laparoscopic appendicectomy9 is equally safe and less postoperative pain and morbidity as compared to open appendicectomy. Laparoscopic appendicectomy is a useful procedure for reducing the hospital stay, return to work early, less complications encountered. With better training now in minimal access surgery now, laparoscopy has been popular now. Conclusion: On analysing the data, we found a definite difference in outcome between open and laparoscopic appendicectomy in consecutively selected patients. The laparoscopic appendicectomy was better than the open appendicectomy with respect to pain, postoperative complications like vomiting, and wound infection rate. Postoperative recovery was good in respect with duration of hospital stay, resumption of diet. The only drawback of laparoscopic appendicectomy was with the duration of surgery. However with the above mentioned advantages outweighs the time drawback for laparoscopic appendicectomy. Overall laparoscopic appendicectomy is better than open appendicectomy in selected patients with acute or recurrent appendicitis.