Complicated appendicitis is associated with longer hospital stays and increased morbidity. In addition, open surgery has its complications such as surgical site infection, incisional hernia, and wound dehiscence. Therefore, the laparoscopic approach is gaining much support as minimally invasive with the benefits of laparoscopic surgery. However, the role of laparoscopic appendectomy remains controversial in the setting of complicated appendicitis in comparison with uncomplicated appendicitis in the general surgical community.
AIM OF THE WORK:
The aim of this study was to compare the outcome of laparoscopic versus open appendectomy in patients with complicated appendicitis regarding operative time, morbidity specificaly postoperative pain and ileus, hospital stay and need for readmission.
PATIENTS & METHODS:
In the period from April 2020 to May 2022, 52 patients with complicated appendicitis were admitted to the GIT Surgical Unit in Alexandria University Medical Hospital. A total of 12 patients were excluded, 5 patients for having lower abdominal scar from previous surgeries, 4 patients for having immobile appendicular mass on examination under general anesthesia and 3 patients for having severe cardiopulmonary comorbidities.
The remaining 40 patients constituted our study pool which were randomly allocated to LA(laparoscopic appendectomy)and OA(open appendectomy) groups with 20 patients per group.
Preoperative assessment: Thorough history, clinical examination, laboratory investigation, imaging as US and CT abdomen.