Roohul Muqim, Mansoor Khan, Mohammad Zarin.
Experience of laparoscopic appendecectomies versus open appendecectomies.
Pak J Med Sci Jan ;26(2):324-8.

Objective: To compare the outcome of laparoscopic and open appendecectomies in terms of operative time and post-operative morbidity. Methodology: This prospective study was done from March, 2008 to March, 2009, at Surgical "C" Unit of Khyber Teaching Hospital, Peshawar. All consecutive appendectomies (open and laparoscopic) performed over this time were included. Demographic details, operative time, conversion, infective post-operative complications and delay in discharge were recorded. The patients were divided into two groups, laparoscopic appendectomies (LA) and open appendectomies (OA). Results: A total of 165 appendectomies were performed, 72 in the LA group and 93 in OA group. Eighteen appendectomies were perforated at the time of operation. The patients’ ages ranged from 12-65 years (median 24 years). Eighty were males and eighty five were females. Operative time in LA group was longer with mean duration of 45 minutes (range 35-75 minutes) compared with 35 minutes (range 30-55 minutes) in OA group. A glove finger was used as extraction bag in 59 (83%) in LA group. LA patients’ wound infection was recorded in12 patients, two out of 72 in LA and 10 out of 93 in OA group. The site of infection was the port of specimen extraction in LA group. Intra-abdominal abscesses complication was observed in one case in the OA group. LA group had shorter hospital stay (mean 1.5 days) than (OA) (mean 3.5 days), and early return to normal activity, 8-15(mean 10.5) days in LA and15-25(mean18.5) days in OA. Conclusion: Laparoscopic Appendectomy (LA) is safe and has major benefits like less post-operative pain, decreased wound infection, early hospital discharge and earlier return to work than Open Appendectomy (OA). LA is recommended in all patients with acute appendicitis if laparoscopy is not contraindicated.

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