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Laparoscopic appendicectomy versus open appendicectomy: a comparative study of clinical outcome and cost analysis — Institutional experience

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Abstract

Background

Laparoscopic appendicetomy had not gained importance against open appendicectomy and it remains controversial in Indian perspective.

Aim

Compare the clinical outcome and cost effectiveness of Laparoscopic Appendicectomy (LA) versus Open Appendicectomy (OA).

Methods

A prospective study for a period of 21 months from Oct. 2005 to June 2007, 249 patients underwent appendicectomy and 200 patients were included in the study. 114 underwent Open appendicectomy and 86 underwent laparoscopic appendicectomy. 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 appendicectomy was better than open appendiectomy 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 < 0.0001HS) and cost of surgery {LA: OA Rs.4225.81: Rs.5560.92 (P <0.0001)}.

Conclusion

Laparoscopic appendicectomy was better than open appendiectomy with respect to wound infection rate, early resumption of oral feeds, postoperative pain, lesser use of analgesics, postoperative hospital stay and return to normal activities. Although above mentioned advantages were at the cost of slightly increased duration of surgery and cost of surgery.

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References

  1. Semm K (1983) Endoscopic appendicectomy. Endoscopy 15: 59–64

    Article  PubMed  CAS  Google Scholar 

  2. Sweeney KJ, Keane FB (2003) Moving from open to laparoscopic appendicectomy. BJS 20:257–258

    Article  Google Scholar 

  3. Klingler A, Henle KP, Beller S et al. (1998) Laparoscopic appendicectomy does not change the incidence of postoperative infectious complications. Am J Surg 175:232–235

    Article  PubMed  CAS  Google Scholar 

  4. Long KH, Bannon MP, Zietlow SP et al. (2001) A prospective randomized comparison of laparoscopic appendicectomy with open appendicectomy: Clinical and economic analyses. Surgery 129:390–400

    PubMed  CAS  Google Scholar 

  5. Dunn EL, Moore EE, Elerding SC, Murphy JR (1982) The unnecessary laparotomy for appendicitis-can it be decreased? Am Surg 48(7):320–323

    PubMed  CAS  Google Scholar 

  6. Deutsch AA, Zelikovsky A, Reiss R (1982) Laparoscopy in the prevention of unnecessary appendicectomies: a prospective study. Br J Surg 69(6):336–337

    Article  PubMed  CAS  Google Scholar 

  7. Kum CK, Ngoi SS, Goh PM et al. (1993) Randomized controlled trial comparing laparoscopic and open appendicectomy. Br J Surg 80:1599–1600

    Article  PubMed  CAS  Google Scholar 

  8. Ortega AE, Hunter JG, Peters JH et al. (1995) A prospective, randomized comparison of laparoscopic appendicectomy with open appendicectomy. Laparoscopic Appendicectomy Study Group. Am J Surg 169:208–213

    Article  PubMed  CAS  Google Scholar 

  9. Hansen JB, Smithers BM, Schache D et al. (1996) Laparoscopic versus open appendicectomy: Prospective randomized trial. World J Surg 20:17–21

    Article  PubMed  CAS  Google Scholar 

  10. Frazee RC, Roberts JW, Symmonds RE et al. (1994) A prospective randomized trial comparing open versus laparoscopic appendicectomy. Ann Surg 219:725–31

    Article  PubMed  CAS  Google Scholar 

  11. Henle KP, Beller S, Rechner J et al. (1996) Laparoscopic versus conventional appendicectomy: A prospective randomized study. Chirurg 67:526–230

    PubMed  CAS  Google Scholar 

  12. Cox MR, McCall JL, Toouli J et al. (1996) Prospective randomized comparison of open versus laparoscopic appendicectomy in men. World J Surg 20:263–266

    Article  PubMed  CAS  Google Scholar 

  13. Temple LK, Litwin DE, McLeod RS (1999) A meta-analysis of laparoscopic versus open appendicectomy in patients suspected of having acute appendicitis. Can J Surg 42:377–383

    PubMed  CAS  Google Scholar 

  14. Vallina VL, Velasco JM, McCulloch CS (1993) Laparoscopic versus conventional appendicectomy. Ann Surg 218: 685–692

    Article  PubMed  CAS  Google Scholar 

  15. Whitworth CM, Whitworth PW, Sanfillipo J, Polk HC Jr. (1988) Value of diagnostic laparoscopy in young women with possible appendicitis. Surg Gynecol Obstet 167(3): 187–190

    PubMed  CAS  Google Scholar 

  16. Richards W, Watson D, Lynch G, Reed GW, Olsen D, Spaw A, Holcomb W, Frexes-Steed M, Goldstein R, Sharp K (1993) A review of the results of laparoscopic versus open appendectomy. Surg Gynecol Obstet 177(5):473–480

    PubMed  CAS  Google Scholar 

  17. Tate JJT, Eisenkop SM, Spirtos TW, Poliakin RI, Hibbard LT (1987) Laparoscopy — a diagnostic aid in cases of suspected appendicitis. Its use in women of reproductive age. Am J Obstet Gynecol 156(1):90–94

    Google Scholar 

  18. Nakhgevany KB, Clarke LE (1986) Acute appendicitis in women of childbearing age. Arch Surg 121(9):1053–1055

    PubMed  CAS  Google Scholar 

  19. Pier A, Götz F, Bacher C (1991) Laparoscopic appendectomy in 625 cases: from innovation to routine. Surg Laparosc Endosc 1(1):8–13

    PubMed  CAS  Google Scholar 

  20. Nowzaradan Y, Westmoreland J, McCarver CT, Harris RJ (1991) Laparoscopic appendectomy for acute appendicitis: indications and current use. J Laparoendosc Surg 1(5): 247–257

    PubMed  CAS  Google Scholar 

  21. Gangal HT, Gangal MH (1987) Laparoscopic appendicectomy. Endoscopy 19(3):127–129

    Article  PubMed  CAS  Google Scholar 

  22. Saye WB, Rives DA, Cochran EB (1991) Laparoscopic appendectomy: three years’ experience. Surg Laparosc Endosc 1(2):109–115

    Article  PubMed  CAS  Google Scholar 

  23. Leape LL, Ramenofsky ML (1980) Laparoscopy for questionable appendicitis: can it reduce the negative appendectomy rate? Ann Surg 191(4):410–413

    Article  PubMed  CAS  Google Scholar 

  24. Penderson AG, Peterson, Wara, Ronning (2001) Randomized clinical trial of laparoscopic versus open appendicectomy. Br J Surg 88:200–205

    Article  Google Scholar 

  25. Robert JK, Tomas (2001) Comparision of open and laparoscopic treatment of acute appendicitis. Am J Surg 182: 211–214

    Article  Google Scholar 

  26. Guller U, Hervey S, Harriett P, Lawrence HM, Peterson ED, Eubanks S et al. (2004) Laparoscopic Versus Open Appendicectomy: Outcomes Comparison Based on a Large Administrative Database. Ann Surg 239:43–52

    Article  PubMed  Google Scholar 

  27. De U (2005) Laparoscopic versus open appendicectomy: An Indian perspective. J Min Access Surg 1:15–20

    Google Scholar 

  28. Namir K, Rodney J, Shirin T et al. (2005) Ann Surg 242(3): 439–448

    Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, Kasturba Medical College, Manipal, Karnataka, India

    K. R. Geetha, Annappa Kudva &  Bhavatej

Authors
  1. K. R. Geetha
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  2. Annappa Kudva
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Correspondence to K. R. Geetha.

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Geetha, K.R., Kudva, A. & Bhavatej Laparoscopic appendicectomy versus open appendicectomy: a comparative study of clinical outcome and cost analysis — Institutional experience. Indian J Surg 71, 142–146 (2009). https://doi.org/10.1007/s12262-009-0038-z

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  • DOI: https://doi.org/10.1007/s12262-009-0038-z

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