Laparoscopic versus open appendectomy Randomized study in king Hussien Medical Centre Amman/Jordan

Laparoscopic appendectomy is a new procedure as compared to laparoscopic cholecystectomy. Laparoscopiccholecystectomy is now considerd a standard method of performing cholecystectomy and has replaced the oldmethod generally throughout the world, while appendectomy could not achieve the similar popularity. In this papera randomized study was done to compare between both laparoscopic and open appendectomy.PATIENTS AND METHOD; In order to compare the two techniques, patients undergoing laparoscopicappendectomy were compared to patients undergoing open appendectomy over a period of 36 months. Thosepatients who had perforated appendicitis were excluded.Patients undergoing laparoscopic appendectomy (N=126) had an average age of 25.7±1.5 (range 16-59). Thesepatients were compared to 159 patients undergoing open.RESULTS; Variables evaluated were operating room time, days until patient tolerated a regular diet, days ofhospitalization, postoperative pain and wound infection rate.Mean operative time was 55minutes for lap. Appendectomy (LA) and 25 minutes for open appendectomy (OA).One day hospitalization in LA and two days in OA.Postoperative pain continued for 12 hours in LA while in OA for 36 hours.Rate of wound infection was 9 out of 159 in OA while none in LA.CONCLUSION; We have to analyze very critically that do we need a procedure which gives us a small scar whichis more cosmetic and acceptable with minimum, hospital stay & off work BUT serious postoperative complicationsor should we stick to the previous gold standard and well established method of open appendectomy with lesserchances of intra-abdominal abscesses / perforation of bowel.We believe it would be very early and immature to say that laparoscopic is superior or can replace openappendectomy.

Keywords:

appendicitis , appendectomy , laparoscopy