Abstract
Backgraound: Open appendectomy (OA) has been the treatment of choice for acute appendicitis since its introduction by Mc-burney in 1884. Laparoscopic appendectomy(LA) though widely practiced, has not gained universal approval. LA was first described in 1983. Some early studies showed equivocal results about benefit of LA. Recent studies showed overall benefit in favour of LA. So far no such a large study was done in any Bangladeshi hospital. So, we decided to do this study with a view to evaluate the therapeutic benefit of LA by comparing with conventional OA.Materials and methods: We collected data of 763 appendectomies done in Jahurul Islam medical college hospital from July 2007 to June 2012 for a period of 5 years. Out of them 448 had conventional OA and 315 had LA. We compared the mean operation time, time of first oral feeding, narcotic analgesic requirement, duration of post operative hospital stay.Results: We found that mean operation time was 33±5.8 minute and 37± 7.5 minute in LA and OA respectively. Duration of post operative hospital stay was 1.2 days shorter in Laparoscopic group. LA required 1.1 shots of less analgesic than OA. Oral feeding was resumed 21 hours earlier following LA compared to OA. Laparoscpic appendectomy was safely performed in paediatric patient without any adverse effect. We also found that, in female patient, concurrent ovarian cysts, tubal pregnancy and endometriosis can be diagnosed and managed laparoscopically in the same sitting.Conclusion: Our study found that laparoscopic appendectomy is an effective and safe procedure irrespective of age and sex of the patient. LA has added advantage of early return of bowel movement, less post-op hospital stay and less requirement of narcotic analgesic.
Highlights
Open appendectomy has been a safe and effective operation for acute appendicitis for more than a century
Several authors proposed that the new technique of laparoscopic appendectomy should be the preferred treatment for acute appendicitis
Laparoscopic cholecystectomy is considered a standard method of performing cholecystectomy and has mostly replaced the old method throughout the world, while appendectomy has yet to achieve such popularity[3]
Summary
Open appendectomy has been a safe and effective operation for acute appendicitis for more than a century. Approximately 7% of the population develope appendicitis in their life time, with peak incidence between the ages of 10 and 30 years, making appendectomy the most frequently performed abdominal operation[1]. Several authors proposed that the new technique of laparoscopic appendectomy should be the preferred treatment for acute appendicitis. Laparoscopic cholecystectomy is considered a standard method of performing cholecystectomy and has mostly replaced the old method throughout the world, while appendectomy has yet to achieve such popularity[3]. Since its introduction by Mcburney in 1884, appendectomy has been a treatment of choice for acute appendicitis[4]. For more than a century, open appendectomy remained the gold standard of treatment of acute appendicitis and for interval appendectomy
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