Laparoscopic appendicectomy versus open appendicectomy: A comparative study of clinical outcome and cost analysis - Institutional experience

Background Laparoscopic appendicetomy had not gained importance against open appendicectomy and it remains controversial in Indian perspective. Aim Compare the clinical outcome and cost effectiveness of Laparoscopic Appendicectomy (LA) versus Open Appendicectomy (OA). Methods A prospective study for a period of 21 months from Oct. 2005 to June 2007, 249 patients underwent appendicectomy and 200 patients were included in the study. 114 underwent Open appendicectomy and 86 underwent laparoscopic appendicectomy. Duration of surgery, postoperative complications, postoperative hospital stay, postoperative pain and requirement of analgesia, resumption of oral feeds, cost of hospital stay and return to normal activities was compared and noted. Result Laparoscopic appendicectomy was better than open appendiectomy with respect to the wound infection rate, early resumption of oral feeds, postoperative pain, lesser use of analgesics, postoperative hospital stay (3.13 days after LA, 4.36 days after OA, P < 0.0001) and return to normal activities (LA group to OA group; 13.86 days to 19.44 days P < 0.0001). Although above mentioned advantages were at the cost of slightly increased duration of surgery (58.29 min in OA group to 74.13 min in LA group P < 0.0001HS) and cost of surgery {LA: OA Rs.4225.81: Rs.5560.92 (P <0.0001)}. Conclusion Laparoscopic appendicectomy was better than open appendiectomy with respect to wound infection rate, early resumption of oral feeds, postoperative pain, lesser use of analgesics, postoperative hospital stay and return to normal activities. Although above mentioned advantages were at the cost of slightly increased duration of surgery and cost of surgery.