A prospective randomized comparative study of laparoscopic appendicectomy versus open appendicestomy in Hospital Universiti Sains Malaysia

Background: Since the demonstration of laparoscopic appendicectomy by K. Semm in 1983, it is performed worldwide though criticized by many. Open appendicectomy is a brief procedure but is definitely associated with morbidity and can cause difficulty in uncertain diagnosis. Laparoscopic appendicec...

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Main Author:	Prakash, Bhoma Anand
Format:	Thesis
Language:	English
Published:	2006
Subjects:	RC705-779 Diseases of the respiratory system
Online Access:	http://eprints.usm.my/47387/1/A%20Prospective%20Randomixed%20Comparative%20Study%20Of%20Laparoscopic%20Appendicectomy%20Versus%20Open%20Appendicectom%20In%20HUSM...2006...mka..-24%20pages.pdf
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spelling	my-usm-ep.473872020-09-23T07:34:09Z A prospective randomized comparative study of laparoscopic appendicectomy versus open appendicestomy in Hospital Universiti Sains Malaysia 2006-11 Prakash, Bhoma Anand RC705-779 Diseases of the respiratory system Background: Since the demonstration of laparoscopic appendicectomy by K. Semm in 1983, it is performed worldwide though criticized by many. Open appendicectomy is a brief procedure but is definitely associated with morbidity and can cause difficulty in uncertain diagnosis. Laparoscopic appendicectomy has been a standard surgical procedure performed in Hospital Universiti Sains Malaysia, but a prospective randomized study comparing various parameters in between LA and OA has not been done before. Objectives: To compare various surgical times, complications and outcomes in between LA and OA in HUSM. Design: Prospective randomized comparative study. Results: This study was conducted in Hospital Universiti Sains Malaysia from February 2006 till November 2006. Total of 97 patients were randomized in the study. Amongst them, 53 patients underwent open appendicectomy (OA) and 44 patients underwent laparoscopic appendicectomy (LA). In the study, 54.6% patients were males and 45.4% were females (P = 0.2). The median age in LA and OA groups was 18 and 20 years respectively. The mean Body Mass Index (BMI) in both groups was same. (22kglm2) Patients in LA group had to wait longer for appendicectomy compared with OA groupand it was 22.2 hours versus 15.8 hours (P = 0.04). The operating time for laparoscopic appendicectomy group as well as for open appendicectomy group was similar (70.2 minutes). Patients in LA group tolerated normal diet significantly earlier (36.6 hours versus 55.4 hours, P = 0.05) and were discharged earlier compared to OA group (2.4 days versus 3.6 days, P=0.2). Eight patients in the laparoscopic group were converted to OA, intra-operatively (18.1 %). Acute appendicitis was the commonest intra-operative finding (72.2%) followed by perforated appendicitis (20.6%). Wound infection rate in OA group was 7.5% compared to 2.8% in LA group. The overall negative appendicectomy rate was 3.1% in the study. Conclusion: The results of this prospective randomized comparative study disapproves the concept that laparoscopic appendicectomy is a prolonged procedure, when compared to open appendicectomy. So the perception that laparoscopic appendicectomy is a prolonged procedure should be avoided. There is early return of bowel function, shorter post operative hospital stay, less pain and lower wound infection rate after laparoscopic appendicectomy when compared to open appendicectomy. Perforated and gangrenous appendicitis can also be handled by laparoscopic appendicectomy safely and are not the contraindications for laparoscopic appendicectomy. Diagnostic laparoscopy should be considered among females in reproductive age group with uncertain diagnosis. 2006-11 Thesis http://eprints.usm.my/47387/ http://eprints.usm.my/47387/1/A%20Prospective%20Randomixed%20Comparative%20Study%20Of%20Laparoscopic%20Appendicectomy%20Versus%20Open%20Appendicectom%20In%20HUSM...2006...mka..-24%20pages.pdf application/pdf en public masters Universiti Sains Malaysia Pusat Pengajian Sains Perubatan
institution	Universiti Sains Malaysia
collection	USM Institutional Repository
language	English
topic	RC705-779 Diseases of the respiratory system
spellingShingle	RC705-779 Diseases of the respiratory system Prakash, Bhoma Anand A prospective randomized comparative study of laparoscopic appendicectomy versus open appendicestomy in Hospital Universiti Sains Malaysia
description	Background: Since the demonstration of laparoscopic appendicectomy by K. Semm in 1983, it is performed worldwide though criticized by many. Open appendicectomy is a brief procedure but is definitely associated with morbidity and can cause difficulty in uncertain diagnosis. Laparoscopic appendicectomy has been a standard surgical procedure performed in Hospital Universiti Sains Malaysia, but a prospective randomized study comparing various parameters in between LA and OA has not been done before. Objectives: To compare various surgical times, complications and outcomes in between LA and OA in HUSM. Design: Prospective randomized comparative study. Results: This study was conducted in Hospital Universiti Sains Malaysia from February 2006 till November 2006. Total of 97 patients were randomized in the study. Amongst them, 53 patients underwent open appendicectomy (OA) and 44 patients underwent laparoscopic appendicectomy (LA). In the study, 54.6% patients were males and 45.4% were females (P = 0.2). The median age in LA and OA groups was 18 and 20 years respectively. The mean Body Mass Index (BMI) in both groups was same. (22kglm2) Patients in LA group had to wait longer for appendicectomy compared with OA groupand it was 22.2 hours versus 15.8 hours (P = 0.04). The operating time for laparoscopic appendicectomy group as well as for open appendicectomy group was similar (70.2 minutes). Patients in LA group tolerated normal diet significantly earlier (36.6 hours versus 55.4 hours, P = 0.05) and were discharged earlier compared to OA group (2.4 days versus 3.6 days, P=0.2). Eight patients in the laparoscopic group were converted to OA, intra-operatively (18.1 %). Acute appendicitis was the commonest intra-operative finding (72.2%) followed by perforated appendicitis (20.6%). Wound infection rate in OA group was 7.5% compared to 2.8% in LA group. The overall negative appendicectomy rate was 3.1% in the study. Conclusion: The results of this prospective randomized comparative study disapproves the concept that laparoscopic appendicectomy is a prolonged procedure, when compared to open appendicectomy. So the perception that laparoscopic appendicectomy is a prolonged procedure should be avoided. There is early return of bowel function, shorter post operative hospital stay, less pain and lower wound infection rate after laparoscopic appendicectomy when compared to open appendicectomy. Perforated and gangrenous appendicitis can also be handled by laparoscopic appendicectomy safely and are not the contraindications for laparoscopic appendicectomy. Diagnostic laparoscopy should be considered among females in reproductive age group with uncertain diagnosis.
format	Thesis
qualification_level	Master's degree
author	Prakash, Bhoma Anand
author_facet	Prakash, Bhoma Anand
author_sort	Prakash, Bhoma Anand
title	A prospective randomized comparative study of laparoscopic appendicectomy versus open appendicestomy in Hospital Universiti Sains Malaysia
title_short	A prospective randomized comparative study of laparoscopic appendicectomy versus open appendicestomy in Hospital Universiti Sains Malaysia
title_full	A prospective randomized comparative study of laparoscopic appendicectomy versus open appendicestomy in Hospital Universiti Sains Malaysia
title_fullStr	A prospective randomized comparative study of laparoscopic appendicectomy versus open appendicestomy in Hospital Universiti Sains Malaysia
title_full_unstemmed	A prospective randomized comparative study of laparoscopic appendicectomy versus open appendicestomy in Hospital Universiti Sains Malaysia
title_sort	prospective randomized comparative study of laparoscopic appendicectomy versus open appendicestomy in hospital universiti sains malaysia
granting_institution	Universiti Sains Malaysia
granting_department	Pusat Pengajian Sains Perubatan
publishDate	2006
url	http://eprints.usm.my/47387/1/A%20Prospective%20Randomixed%20Comparative%20Study%20Of%20Laparoscopic%20Appendicectomy%20Versus%20Open%20Appendicectom%20In%20HUSM...2006...mka..-24%20pages.pdf
_version_	1747821767211089920

A prospective randomized comparative study of laparoscopic appendicectomy versus open appendicestomy in Hospital Universiti Sains Malaysia

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