Birju Shah, Nikunj Vaidhya, M. M Anchalia
Abstract: Open appendicectomy is time tasted technique while laparoscopic appendicectomy is newer concept. In present study total 75 patients with appendicitis were selected, 40 of which underwent SIOA (small incision open appendicectomy) and 35 underwent LA (laparoscopic appendicectomy). SIOA was done via 2-3 cm incision at McBurneys point and LA was done via standard 3 port technique. Both the technique were compared in terms of operative time, post-operative pain, analgesic requirement, post-operative length of stay, time to return to daily activities, complications, conversion rate, cost and cosmetic outcome. The results showed that SIOA is better than LA in terms of operative time (mean 44.41 vs. 56.44 minutes), time to return to daily activity (mean 8.22 vs. 9.13 days) and complications (6.66 % vs. 10 %). SIOA and LA were comparable in terms of Post-operative pain (mean 7.09/4.75/1.34 vs. 6.94/4.94/1.28 at POD1/2/10), analgesics requirement (mean 2.53/5.19 vs. 2.84/5.97 for injectable/oral doses), post-operative hospital stay (mean 2.25 vs. 2.41 days) and cosmetic effect. The cost was higher in LA group compared to SIOA. Excluding obese patient, conversion rate from SIOA to OA and LA to OA was 5.17 % for SIOA vs. 5.71 % for LA. In obese patients SIOA was converted to OA in 5 out of 6 patients and in LA was done without much trouble in obese patients as well. SIOA is the method of choice in thin and lean patients as LA offers no advantage over SIOA in this group while increasing costs.LA is the preferable method for obese patients. SIOA takes less time than LA.SIOA is comparable to LA in terms of post-operative pain, analgesics requirement, hospitals stay and return to daily activities. SIOA is more economic and cost-effective than LA.SIOA is cosmetically as good as LA.
Keywords: LA-laparoscopic appendicectimy, SIOA-small incision open appendicectomy, cosmetic results, cost effectiveness, duration of surgery