Laparoscopic versus Open Appendectomy: A Jordanian Perspective

Objective: To determine whether there is an advantage to Laparoscopic Appendectomy compared with Open Appendectomy. Background: Laparoscopic Appendectomy (LA) is relatively new in Jordan. Although it is widely practiced worldwide, it has not replaced the open conventional procedure, may be because there are no clear-cut benefits of Laparoscopic Appendectomy over Open Appendectomy (OA), in the literature. Materials and Methods: We did a review of the records of 50 LAs for acute appendicitis done by the second author at King Abdullah University Hospital (KAUH) from June, 2003 till October, 2005 and compared them to 50 randomly selected OAs done by the same surgeon at the same period of time. The studied points included the patients demographic data, operating time, post-operative analgesia, postoperative complications, the length of hospital stay and time taken to return to work or activities. Differences were considered statistically significant at a P-value that equals or is less than 0.05. Results: Patients’ demographics and operative findings were similar in both groups. There was no conversion to open appendectomy. Mean duration of surgery was 35.4 minutes for Laparoscopic Appendectomy and 33.1 minutes for Open Appendectomy (p 0.1). The rate of wound infection and other complications for LA was 0%, while for the OA group, 4 (8%) patients had wound infection (P 0.058). The LA group had reduced post-operative analgesia requirements (P 0.0001). The LA group had a shorter hospital stay (P 0.0001), and a significantly shorter time taken to be able to return to work (P 0.0001). Conclusion: Laparoscopic Appendectomy has significant advantages over Open Appendectomy with respect to length of hospital stay, the shorter convalescence and sooner return to daily activities, with less complication rate and equal or less operative time. We highly recommend the use of laparoscopic technique as the treatment of choice for acute appendicitis.