Comparing laparoscopic appendectomy to open appendectomy in managing generalised purulent peritonitis from...

Area of Science:

• General Surgery
• Minimally Invasive Surgery
• Gastrointestinal Surgery

Background:

• Complicated appendicitis with generalized purulent peritonitis presents a significant surgical challenge.
• Comparing laparoscopic and open appendectomy outcomes is crucial for patient management.

Purpose of the Study:

• To compare the outcomes of laparoscopic versus open appendectomy for generalized purulent peritonitis from complicated appendicitis.
• To evaluate key parameters including theatre duration, complications, and hospital stay.

Main Methods:

• Retrospective analysis of 120 patients with generalized purulent peritonitis from complicated appendicitis.
• Comparison of outcomes between 58 patients undergoing open appendectomy and 62 patients undergoing laparoscopic appendectomy.
• Analysis of demographic data, theatre duration, complication rates, diet commencement, and hospital stay.

Main Results:

• Laparoscopic appendectomy had longer theatre duration (116 vs. 87 minutes) and higher intra-abdominal sepsis rates (13% vs. 9%).
• A statistically significant decrease in wound sepsis was observed in the laparoscopic group.
• No significant difference in other postoperative complications, diet commencement, or hospital stay was noted.
• Open appendectomy patients spent more time in intensive/high care units (3.7 vs. 2.0 days).

Conclusions:

• Laparoscopic management of generalized purulent peritonitis from complicated appendicitis is feasible and safe.
• Both laparoscopic and open approaches offer comparable outcomes.
• The laparoscopic approach is associated with a lower rate of postoperative wound sepsis.