A prospective comparative study on appendectomy for complicated acute appendicitis via open versus laparoscopic approach

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Abstract

Introduction
One of the most common causes of lower abdominal pain encountered in the emergency room is acute appendicitis. It is the most common cause of acute abdomen in young patients. Complicated appendicitis includes perforated, gangrenous appendicitis, peri-appendicular mass, or abscess. Appendectomy for acute appendicitis is the standard treatment.
Objectives
The aim of this study was to compare open and laparoscopic appendectomy in the management of complicated acute appendicitis with respect to operative outcomes, including operative time and intraoperative complications, and postoperative outcomes, including start of oral intake, length of hospital stay, return to normal activities, and early postoperative complications as wound infection, and postoperative sepsis and ileus.
Patients and methods
This is a prospective randomized controlled clinical trial performed from June 2021 to June 2022. The study included 50 patients with complicated acute appendicitis. Patients were divided into two groups according to the type of the procedure done for appendectomy whether open or laparoscopic. Each group included 25 patients. Randomization was done using the closed envelope method.
Results
The mean operative time was statistically higher in the laparoscopic group, with a value less than 0.001. There was no statistically significant difference between both groups regarding start of oral feeding and hospital stay. The mean duration of return to normal activity and the rate of wound infection were statistically higher in the open group.
Conclusion
Laparoscopic appendectomy is a safe and feasible surgical option for complicated acute appendicitis. Despite having more operative time, it has less rate of postoperative complications with early return to normal activity.

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