EVIDENCE-BASED COMPARISON OF LAPAROSCOPIC AND OPEN APPENDECTOMY TECHNIQUES IN IRAQ

Abstract

Background: Appendicitis is the most common surgical abdominal emergency in the world. Laparoscopic appendectomy is the optimal treatment for appendicitis. Objective: This study showed clinical outcomes comparing laparoscopic and open appendectomy in Iraq. Patients and methods: A comparative study was conducted on 65 patients with appendicitis, aged between 15 and 40, treated between 2014 and 2016. The sample included patients over the age of 15 and less than 40 years old. The objective of this study is to analyse the data from surgical databases of patients with regard to the location of pain, the stage of appendicitis, concomitant diseases, the method of surgical intervention (open or laparoscopic), the administration of antibiotic prophylaxis, the duration of the surgical procedure, the intensity of postoperative pain, the occurrence of complications, and mortality. Results: The surgical findings were entered into databases of patients. The operative time was 60.30 ± 10.30 minutes, with two cases of bleeding and one case of ICU admission. There were no mortalities, three cases of intraoperative complications, a length of hospital stay of 1.12 ± 0.22 days, and a time to first bowel movement of [...] days. The mean length of hospital stay was 1.10 ± 0.26 days, with oral analgesics being administered for 3.05 ± 0.66 days and parenteral analgesics for 1.04 ± 0.24 days. Postoperative complications included five cases, where the most common factor prevalence in patients shown surgical site infection, which included only three patients in the LA group, while the OA group findings included an operative time was 45.84 ± 15.20 minutes, with five cases of bleeding, as well as four cases of ICU admission and a mortality rate of zero, five cases of intraoperative complications, where a length of hospital stay of 1.26 ± 0.82 days, along with a time to first bowel movement of 1.13 days, which the mean length of hospital stay was 5.00 ± 0.29 days, and oral analgesics which administered was 3.68 ± 0.40 days and parenteral analgesics was 1.23 ± 0.56 days, where postoperative complications had 15 cases, and the most common being surgical site infection got 7 cases, and intrabdominal abscess got 4 cases. Conclusion: This study showed that laparoscopic appendectomy shows superior clinical outcomes in treating patients with appendicitis compared to open surgery.