A Quality of Life Comparison of Laparoscopic and Open Approaches in Acute Appendicitis: A Randomised Prospective Study

Abstract

Background and objectives: The study aimed to evaluate the utility of a laparoscopic approach in the management of patients with right lower abdominal pain and in the quality of life after the operation.Methods: Patients with suspected appendicitis were included in the study. They were randomly assigned either to treatment with a traditional open approach or with a laparoscopic approach. The patients’ data, including demographic data, complications and gastro-intestinal quality of life index scores, were collected at the 6th week and 6th month and compared between the groups.Results: Overall, 83 appendectomies were performed. Other pathologies were ovulation bleeding, ovarian cyst, Meckel’s diverticulum, ectopic pregnancy and leiomyoma of the uterus. Negative appendectomy rate was 7%. Severe infection occurred in five of the open group. The advantages of the laparoscopy also showed significantly in hospital stay (55.80 ± 20.97 hours vs. 75.06 ± 35.14 hours), the need for narcotics and in visual analog score, as well as in the gastrointestinal quality of life index (85.88 ± 9.73vs101.30 ± 9.31). The quality of life is still better in the long-term (95.14 ± 8.45 vs120.36 ± 10.25). When the groups were compared according to the subgroups of gastro-intestinal quality of life index, except for disease-specific items, in all categories a significant improvement was seen in the laparoscopically treated patients. This improvement was observed in the follow-up period also. However, the hospital costs (987.50 ± 77.25 USD vs. 406.27 ± 100.59 USD) and operative time (56.25 ± 10.9 vs. 49.41 ± 11.76 minutes) still continued to be a problem for the laparoscopic group.Conclusion: Laparoscopic appendectomy is a safe method, which also has advantages of diagnostic procedure for other pathologies, a better quality of life both in the early and late period, and a short hospital stay. The important advantage is also seen in the late period with better quality of life.