Comparison of Open and Laparoscopic Appendicectomy in Rural Teaching Hospital

Background: Appendicitis is a common surgical emergency with a lifetime risk of appendectomy being 9.6 to 9.8 %. Open and laparoscopic approaches are being advocated with similar benefits. Aim and Objective: Our study aims to compare the outcomes in open and laparoscopic appendectomies in a teaching hospital in rural Maharashtra. Material and Methods: This is an observational study of 114 consecutive patients who underwent appendectomy from August 2017 to July 2020 in the department of surgery at a rural medical college and teaching institute. Sixty-eight patients of open appendectomy (43 acute cases and 25 chronic cases) and 46 of laparoscopic appendectomy (20 acute cases and 26 chronic cases) were included in the study. We investigated operative time, length of hospital stays, postoperative pain, intravenous analgesia complication rate and cost between the two groups. Results: We observed longer operative time (51.26 ± 11.67 vs 33.69 ± 10.27 minutes for open, P < 0.0001) and shorter postoperative stay (LA vs OA: 3.67 ± 0.92 vs 5.71 ± 1.49 days respectively P < 0.0001) for the laparoscopic surgery(LA) group as compared to open appendectomy(OA). Postoperative intravenous analgesic use was less in the laparoscopy group (2.38 days vs 4.10 days, P < 0.0001). The cost difference was not statistically significant. There was no significant perioperative morbidity in either group. Conclusion: Laparoscopic appendicectomy is associated with lesser use of postoperative analgesics, fewer complications, shorter hospital stay, early return to routine work. Laparoscopic appendicectomy was found to have longer duration of surgery.