AbstractIntroduction: Acute appendicitis is one of the most commonly encountered surgical conditions with a lifetime incidence of 7–9%. Early diagnosis with prompt surgery is the preferred treatment option to prevent complications. Conventional appendicectomy has been the gold standard for the treatment of acute appendicitis. The major benefits to patients undergoing laparoscopic appendectomy are early hospital discharge, reduced postoperative pain, decreased wound infection, Early return to full activity and a better cosmetic scar. Aim: To compare the efficacy of laparoscopic approach over conventional appendicectomy in emergency uncomplicated acute appendicitis. Material and Methods: The present interventional clinical study was carried out at teaching government hospital during December 2014 to November 2016 and total 178 patients underwent appendicectomy. The study subjects were the patients who have undergone emergency appendicectomy for uncomplicated acute appendicitis, all with modified Alvarado score >7. Results: Out of total 178 patients 130(73.03%) underwent Conventional Appendicectomy and 42(23.59%) had laparoscopic appendicectomy. The mean duration of surgery was longer in laparoscopic group than conventional group and the difference was statistically significant. Liquid diet and solid diet were started earlier in laparoscopic group than conventional group. The postoperative pain was less in laparoscopic group as compared to conventional group. In the laparoscopic appendicectomy group, 3(7.14%) patients had wound discharge, 3 patients had burning micturition (7.14%). While in the conventional appendicectomy group, 13(9.55%) patients had wound discharge and wound dehiscence was seen in 5(3.67%) patients. The mean postoperative hospital stay was longer in laparoscopic group than conventional group. The difference was statistically significant. It was found that laparoscopic appendicectomy was costlier than conventional appendicectomy. Limitation of Our Study: Long-term complications of both laparoscopic and conventional appendicectomy could not be studied. Conclusion: The present study shows that laparoscopic appendicectomy provides benefits over conventional appendicectomy in terms of a shorter hospital stay, less postoperative pain, earlier resumption of oral feeds and reduced wound infection rate. Although the above–mentioned benefits were at the cost of significantly longer duration of surgery and higher cost associated with laparoscopic approach over conventional appendicectomy also feasibly in teaching government hospital is also a hindering factor.
Keywords: Appendicectomy, Conventional, Laparoscopic, Acute appendicitis.