Early Laparoscopic Appendicectomy in Complicated Appendicitis – A Retrospective Analysis of Our Experience
Journal Title: Journal of Medical Science And clinical Research - Year 2015, Vol 3, Issue 3
Abstract
Background: Laparoscopic approach for complicated appendicitis including appendicular mass remains controversial. Outcomes of laparoscopic approach for higher grades of appendicitis are reviewed. Methods: Over a period of four years 152 patients undergo appendectomy in our General Surgical Unit. Among them 59 patients had complicated appendicitis. As was our practise based on our experience, all these 59 patients were taken up for Laparoscopic Appendicectomy within 24 hours of admission. About 3% (2 cases) of cases had to be converted to open because of various reasons (dense caecal or ileal adhesions). The other 57 patients were successfully operated upon by the minimally invasive procedure. All patients were uniformly treated with parenteral broad spectrum antibiotic for a minimum of 48 hours starting from the time of admission. Age of patients was ranging from 11 to 54. Various parameters analysed are length of hospital stay, return to full activity, and complication rates. Results: Results of early laparoscopic appendicectomy for complicated appendicitis in our hospital were reviewed. The mean operating time for these 57 patients was 55 minutes. The average hospital stay was 3.5 days. Most of the patient returned to complete activity by day 5. There was no immediate postoperative complication in any of these cases. One patient had stump appendicitis with abscess after 9 months, who underwent open abscess drainage, and appendicular stump excision. One patient had port site hernia after 2 years. Follow up data was available on all these patients for a minimum period of 6 months. Conclusion: From our collective experience on such cases of complicated appendicitis we conclude that, in spite of slightly increased operating time than uncomplicated cases, all patients with complicated appendicitis should be consideredfor the minimally invasive procedure on the same admission, as the benefits of early laparoscopic procedure definitely outweigh the demerits of open procedure or interval appendicectomy.
Authors and Affiliations
Habeeb Mohammed. S
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