Laparoscopic Versus Open Appendectomy for the Treatment of Complicated Acute Appendicitis
2020
Background and Objective: Acute appendicitis is one of the most common and at the same time lethal if not treated promptly. Failure to treat this medical condition in a timely manner then it can lead to major complications that endanger the patient’s health. In these cases, surgical treatment can be done in an open or laparoscopic method. Despite some limited studies comparing the results of these two therapies, there is still insufficient information in patients with this complicated situation. The aim of this study was to evaluate the results of these two therapies in patients with complicated acute appendicitis. Materials and Methods: In this randomized controlled clinical trial, 52 patients with complicated acute appendicitis in the laparoscopic surgery group and 56 patients in the open surgery group were studied. Primary outcomes in this study were duration of surgery and secondary outcomes including wound infection, intra-abdominal abscess, postoperative pain, miscarriage, hospitalization, and need for re-surgery that were compared between the two groups. Results: Both groups were matched for age (mean 31.0 years in laparoscopic surgery group, 30.5 years in open surgery group, p = 0.81) and gender (28 men in laparoscopic surgery group, 32 men in surgical group, p = 0.73). The mean duration of surgery in the laparoscopic group was significantly longer (mean 66.8 vs. 55.1 min, p <0.001). In contrast, mean duration of hospitalization (85.2 vs 98.6 hours, p <0.001) and mean postoperative pain severity (6.3 vs 7.2, p <0.001) was more significant high in open surgery group. In other cases there was no significant difference between the two groups. Conclusion: Although in surgical treatment of complicated acute appendicitis the duration of laparoscopic surgery is longer than the open method, but the duration of hospitalization and pain intensity in laparoscopic method is significantly reduced.
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