Laparoscopic Appendectomy Versus Open Appendectomy for Acute Appendicitis: A Prospective Comparative Study

Background Appendicitis is the most common cause for acute abdominal pain. Laparoscopic appendectomy is an effective alternative to open appendectomy. It is a minimally invasive results in less postoperative pain, less wound infection, early return to normal work and less morbidity compared to open appendectomy. Both surgical methods are safe but there has been a controversy about which surgical procedure is the most appropriate. Objective To compare the outcomes of laparoscopic versus open appendectomy. Method In this prospective study, from January 2015 to April 2016, 212 cases of acute appendicitis were included. Diagnosis was based on Alvarado score of seven or above. Patients were distributed into two groups where every alternate patient was operated either open or laparoscopically. The groups were compared in terms of operative time, postoperative pain, postoperative wound infection, other morbidities and length of hospital stay. Result Of 212 patients, 106 underwent open and 104 underwent laparoscopic appendectomy. Other two patients, in whom laparoscopy was converted to open procedure, were excluded from the study. The mean operating time in laparoscopic appendectomy group was 44.57 ± 6.68 minutes and in open appendectomy group, was 36.34 ± 7.47 minutes (p < 0.05). The visual analog scale scores at 6th, 12th, 24th and 48th hours were higher in open appendectomy group compared to laparoscopic appendectomy group (p< 0.05). The hospital stay was 2.63 ± 0.60 days in laparoscopic appendectomy group and 3.26 ± 0.68 days in open appendectomy group (p < 0.05). Surgical site infection in laparoscopic appendectomy and open appendectomy group were 3.8% and 14 % respectively (p< 0.05). Conclusion In laparoscopic appendectomy group, there is lower incidence of wound infection, lesser postoperative analgesic requirement and shorter hospital stay in comparison to open appendectomy. Though, the operative time is more with laparoscopic appendectomy, it can be considered as the gold standard for surgical treatment of acute appendicitis.