EARLY LAPAROSCOPIC APPENDICECTOMY IN MANAGEMENT OF APPENDICEAL MASS
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 59
Abstract
BACKGROUND Acute appendicitis is a most common surgical emergency. Approximately, 10% of acute appendicitis patients present with appendiceal mass. Surgical management of appendiceal mass remains controversial. Majority of surgeons preferred conservative treatment. This study was carried out to evaluate our experience in early laparoscopic appendicectomy (LA) in the management of appendiceal mass. MATERIALS AND METHODS For the study, a total of 48 patients who were admitted with a diagnosis of appendiceal mass in the Department of Surgery during the period from July 2015 to December 2016 were included. The selection of the patients was done on the basis of the clinical history, clinical examination, laboratory tests and radiological findings. All 48 patients who were diagnosed with appendiceal mass underwent laparoscopic appendicectomy. RESULTS Laparoscopic appendicectomy was attempted in all 48 patients. There were 32 males and 16 females within age range of 10 to 80 years, maximum in 30 - 50 years age group. One case was converted to open and segmental colectomy was performed due to dense adhesion with unhealthy base and gangrenous caecal wall. The base of the appendix was sutured in 7 cases and drain was left in for 3 - 4 days. Endoloop was used in remaining 40 cases. There was difficulty in localisation of appendix and bleeding was noted in 4 cases during intraoperative period. The average operative time was 80 minutes (range from 30 to 120 minutes) and average postoperative hospital stay was 4 - 5 days (Range from 2 to 7 days). Except for mild fever which occurred in four patients, no major postoperative complications were seen. CONCLUSION Early laparoscopic appendicectomy during the index admission of patient with an appendiceal mass is feasible and safe. It also avoids the need for a second admission and misdiagnosis.
Authors and Affiliations
Shyamchand Singh S, Javan NG. , Khumallambam Ibomcha Singh, Tozo Luwang
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