LAPAROSCOPIC VERSUS OPEN APPENDECTOMY - A PROSPECTIVE ASSESSMENT

A prospective study of 200 consecutive patients with suspected acute a ppendicitis was performed to compare open and laparoscopic appendicect omy. Formal randomization was precluded by instrument availability. So me 100 patients underwent laparoscopic appendicectomy (conversion to l aparotomy was carried out in five) and 100 had conventional surgery. T he groups were similar in sex ratio, age, degree of appendiceal inflam mation and antibiotic treatment. The mean duration of open appendicect omy was 46 min and of the laparoscopic procedure 51 min (P not signifi cant). Postoperative complications in patients who underwent laparosco pic appendicectomy included: intraabdominal abscess (two patients), wo und infection (one), early bowel obstruction (four; all resolved with medical treatment) and umbilical haematoma (two). There were no reoper ations in the immediate or late postoperative period. Complications af ter open operation were: wound infection (seven patients) (P < 0.05), early bowel obstruction (five; three resolved with medical treatment, two required surgery) and haematoma of the surgical wound (one). The m ean hospital stay was 4.8 days for laparoscopic appendicectomy and 6.0 days for the open operation(P < 0.05). There were no deaths.