Effectiveness Of Laparoscopic Appendectomy Research Articles

Effectiveness of laparoscopic appendectomy over open appendectomy in a tertiary care centre: a retrospective study

Background: Acute abdomen is the most common surgical clinical entity. Appendectomy is the treatment of choice for acute appendicitis. It can be done by open or laparoscopic method. Laparoscopic appendectomy gives a better evaluation of the peritoneal cavity than that obtained by open approach and also facilitates other differential diagnosis. Methods: Patients admitted under surgical unit from December 2020 to June 2022, at Mamata Medical College and Hospital, Khammam. A study was carried out on 100 patients were admitted with 50 patients undergoing laparoscopic appendectomy and the remaining 50 patients undergoing open appendectomy. ln both study groups the outcome was assessed based on the intra operative finding, operative time, post-operative recovery, post-operative complications, and length of hospital stay. Results: Findings of the patients undergoing open and laparoscopic appendectomy were compared and recorded. After analysing the data, there were significant differences between the two procedures with laparoscopic appendicectomy being better in respect to post operative pain perception, duration of analgesics used in days, postoperative infection, postoperative bleeding, post operative duration of hospital stay days and return to normal work in days with p value being significant. Conclusions: The laparoscopic appendicectomy was better than open appendicectomy with respect to pain score, lesser use of analgesics, post operative complications like vomiting, ileus and wound infection rate. Only drawback of laparoscopic appendicectomy was with the duration of surgery. Overall laparoscopic appendicectomy is better than open appendicectomy in selected patients with acute/recurrent appendicitis.

Safety and effectiveness of laparoscopic appendectomy in patients undergoing abdominal surgery

Abstract Background Although laparoscopic appendectomy is the criterion-standard treatment method for acute appendicitis, the decision on laparoscopic or conventional technique is usually made according to individual perspectives. The reasons affecting this individual point of view include whether the disease is complicated, the infrastructure of the hospital, the patient's comorbid factors, and previous intra-abdominal operations. This cross-sectional retrospective study aimed to evaluate the safety of laparoscopic appendectomy in patients with a possible diagnosis of “appendicitis” in patients who had undergone previous abdominal surgery. Methods Patients who were operated on with the diagnosis of acute appendicitis in our clinic between March 2021 and March 2022 were retrospectively analyzed. Patients were grouped as those with a history of abdominal surgery (group 1) and without (group 2). In addition, demographic data of the patients (age, sex), body mass index, presence of comorbid disease, history of abdominal surgery, operation time, rate of conversion to open surgery, postoperative hospital stay, complications, and radiological and pathological appendix size were recorded. Results A total of 181 patients were included in the study. The mean age was 32.51 ± 15.89 years. Seventy (38.7%) of the patients were female, and 111 (61.3%) were male. Thirty-four patients (18.8%) were in group 1, and 111 patients (81.2%) were in group 2. The mean age, body mass index, and operation time in group 1 were statistically higher than in group 2 (P < 0.001). However, there was no difference between the groups regarding postoperative hospital stay, radiological and pathological appendix size, conversion to open surgery, and presence and severity of complications (P > 0.05). Conclusion In line with the data the authors have shown in their study, a laparoscopic appendectomy can be performed safely in patients who have undergone abdominal surgery. Therefore, surgeons should not stray from a laparoscopic appendectomy when they see an abdominal incision.

P590 ADVANCED-UC TRIAL: AppenDectomy Vs ANti TNF-a in inducing Clinical and EnDoscopic remission in left-sided Ulcerative Colitis – A Randomized Clinical Trial

Abstract Background A considerable amount of evidence supports the immunomodulatory role of the appendix in the development and course of Ulcerative Colitis. Indeed, the appendix could act as either a reservoir for commensal bacteria or as the "priming site” for the cytokine production and the immunological cascade triggering inflammation in the colon. Therefore a potential role of the appendix in etiopathogenesis, treatment, prophylaxis and in the colectomy rate in UC has been hypothesized. Given the lack of randomized data on the topic, the ADVANCED-UC trial aims to assess to role of appendectomy in inducing remission in refractory left sided Ulcerative Colitis. Methods Consecutive patients with left-sided UC refractory to conventional treatment and candidate to biologics will be randomized in the standard group (anti-TNF alpha) or in the intervention group (laparoscopic appendectomy). Primary endpoints: Steroid Free Clinical Remission, Endoscopic remission and Assessment of Quality of Life at 3 and 12 months. Secondary endpoints: Clinical Response, Failure Rate, Complication rate and Histological Remission at 3 and 12 months; Colectomy rate at 12, 24 and 60 months. To obtain a significance level of 5% and a test power of 90%, it is required a sample size of 148 patients (74 patients per group), assuming a 25% success rate in the control group and a 50% success rate in the experimental group. The study has been already approved by our local IRB (num. 340/21) and has been granted with the Spring Award from the Surgical Research Network by the Crohn’s and Colitis Foundation (CCF). We plan to start the enrollment in 2023 and we are currently recruiting potential participating centers, to run a multicenter, randomized controlled trial Results The findings of this study could support a change of treatment paradigm for patients refractory to conventional therapy: indeed, while an appendectomy can protect UC patients from the future use of expensive or potentially dangerous drugs, or even major surgery, the initial additional costs and potential side effects of appendectomy will be offset by substantial health gains and reduced costs later in time. On the other hand, patients undergoing appendectomy which do not experience disease remission and are forced to start biologics will be followed up for the evaluation of the colectomy rate to evaluate the possible synergic effect of appendectomy and biologics in reducing the need for total colectomy in the long term. Conclusion The aim of this study is to define the role and effects of laparoscopic appendectomy as a therapeutic option in patients with UC refractory to conventional therapy who are candidates, in the first instance, for biologic anti-TNF-a therapy.

Advantages and disadvantages of laparoscopic procedures in relation to the open method in pediatric surgery

There are many studies which present advantages and disadvantages of the use of both minimally invasive and open method procedures in pediatric sur¬gery. This paper highlights the advantages of minimally invasive surgery and the resulting conclusions for use in clinical practice (e.g. the use of laparoscopy in children is associated with significantly less postoperative stress). The disadvantages of the described surgical techniques and other possible complica¬tions observed after the use of laparoscopic techniques and the open method are also presented. It was emphasized that surgical trauma, regardless of the surgical method used, causes not only a post-traumatic immune-inflammatory response of the body, but is often associated with the risk of developing infections (local or generalized) and the occurrence of recurrences. The study focuses on summarizing the current state of knowledge on minimally invasive pediatric surgery, in particular on the effectiveness of laparoscopic appendectomy, laparoscopic inguinal hernia repair and laparoscopic procedures used in pediatric oncology, taking into account postoperative immune response disorders. Moreover, progress was analyzed in the use of minimally invasive robotic surgery, which becomes an increasingly common method of treatment of many typical surgical diseases in children.

The Effect of Laparoscopic Appendectomy and Open Appendectomy on the Quality of Life

The Effect of Laparoscopic Appendectomy and Open Appendectomy on the Quality of Life