Laparoscopic versus open appendectomy in the management of chronic appendicitis

Abstract

Background The term ‘chronic appendicitis’ (CA) is still clearly undefined. However, once established, it necessitates appendectomy, which could be performed via open or laparoscopic approaches. Comparisons between the two approaches have been made in acute appendicitis cases, with no previous trials including CA patients. That is why we conducted this study to compare these two approaches in the management of CA patients. Methodology 50 CA were included in our prospective trial, and they were randomly assigned into two groups; the OA group (25 open appendectomy patients) and the LA group (25 laparoscopic appendectomy cases). Results The statistical analysis revealed no significant differences between the two groups regarding most preoperative characteristics. The laparoscopic approach was associated with significant prolongation in operative time that had an average of 1 h in the LA group, while it ranged between 0.5 and 1 h in the OA group (P = 0.005). Nonetheless, laparoscopy led to a significantly better postoperative recovery profile, manifested in the shorter hospitalization period (1 vs. 2 days in the open approach) and less postoperative pain (all patients with mild pain compared with moderate pain in the open group). Only 2 (8%) casesexperienced temporary vomiting in the OA group. Conclusion Laparoscopy is superior to the open approach in the management of chronic appendicitis patients. It is associated with a better analgesic profile, a shorter hospitalization period, and a better chance of detecting other concomitant intraabdominal pathologies. However, the increased operative time should be considered.