Article Abstract

Has laparoscopic approach replaced the open technique to perform appendectomy?—evolution over more than a decade

Authors: Muhammad Tayyab-ul-Hasan Siddiqui, Rizwan Sultan, Hasnain Zafar, Umar Farooq Bhatti, Fatima Shaukat, Noman Shahzad

Abstract

Background: Approximately 8% of the population suffers from acute appendicitis during the second and third decade of life. Appendectomy remains the recommended treatment for patients suffering from acute appendicitis. Lack of laparoscopic surgical expertise and relatively high cost have hindered the adoption of laparoscopic approach to appendectomy especially in developing countries. Objective of our study is to report adaptation trend of laparoscopic appendectomy over a period of 12 years and lessons learnt from it.
Methods: All adult patients of age 16 years and above, admitted with acute appendicitis and underwent laparoscopic appendectomy from January 01, 2004 to December 31, 2015 were included in the study. Data was entered and analyzed using SPSS version 22.
Results: A total of 1,163 patients underwent laparoscopic appendectomy during the study period out of which 831 met inclusion criteria. Proportion of patients who underwent laparoscopic appendectomy as opposed to open surgery increased over time. In 2004 only 13% of the cases were attempted laparoscopically while this proportion was 100% in 2015 (P<0.001). Conversion to open was done in 7% [59] cases mainly due to dense adhesions of the appendix to surrounding structures. Mean duration of surgery was 64.5 (+/−23) minutes. Overall negative appendectomy rate was 7.82%. Surgical site infection was the most common post-operative complication affecting 4.5% [37] of our patients; this included 19 (2.28%) patients with intra-abdominal abscess.
Conclusions: Laparoscopic appendectomy has replaced open technique as treatment of acute appendicitis and results are favorable.