Mini-incision open appendectomy versus laparoscopic appendectomy: An experience in a rural hospital

There is still no consensus about whether laparoscopic appendectomy should be performed in selected cases or routinely in all cases for treatment of acute appendicitis. Especially for rural hospitals with laparoscopic equipment shortages, it is critical to develop surgical methods alternative to LA. This prospective study aimed to compare mini-incision open appendectomy (MOA) and laparoscopic appendectomy (LA) procedures.

A total of 102 patients who had been operated on by a single surgeon for acute appendicitis between July 2018 and February 2020 and whose body mass index (BMI) was <30 were included in this study. Fifty-one patients were operated on with MOA and 51 with LA technique. The patients were evaluated concerning operation time, postoperative pain, hospital stay, postoperative infectious complications and cost-effectiveness.

Operation time was shorter in the MOA group than LA group (p<0.001). VAS scores at postoperative 12th and 24th hours were significantly lower in the MOA group than those in the LA group (p<0.001). Total hospitalization costs were lower in the MOA group than those in the LA group (p<0.001). No significant difference was found between the two groups concerning length of hospital stay and postoperative infectious complications (p=0.061 and p>0.999, respectively).

Mini-incision open appendectomy is a reliable method in patients with acute appendicitis who have a BMI of <30 and it is superior to laparoscopic appendectomy concerning the operation time, postoperative pain and cost.