Comparison of Wound Infection rate in Open Appendectomy (OA) vs Laparoscopic Appendectomy (LA)

Background: There are two methods for removal of appendix: Conventional Open Appendectomy and Laparoscopic Appendectomy. Open appendectomy technique is associated with shorter operating time, more post operative pain, and more wound related complications. On the other hand, Laparoscopic appendectomy is associated with reduced infection rates, lesser post operative pain, early return to work, better cosmesis, but at the expense of longer duration of operation. None of the local studies so far have succeeded in proving statistically significant difference in frequency of wound infection between the two groups. This study has been designed with a large sample size to give a clear picture regarding wound infection in both treatment modalities. Aim: To compare frequency of wound infection following open versus laparoscopic appendectomy. Methods: Study was conducted at North Surgical Unit, Mayo Hospital, Lahore. This was a prospective randomized controlled trail. Total 300 patients who fulfill the inclusion criteria were included in the study. Patients were randomly divided into 2 groups i.e., those undergoing laparoscopic appendectomy (LA group) and those undergoing open appendectomy (OA group) on arrival in operating suite by pulling an envelope method. There was no ethical issue associated with this study (certificate attached). Each group was prepared for surgery in the same manner. For data entry and analysis SPSS version 10 was used. Results: Mean age of patients in Group-OA and in Group-LA was 23.40 +/- 9.93 and 25.20 +/- 6.52 years respectively. Overall female patients were greater as compared to male patients. None of the patients in both treatment groups had infection at 30th day. Whereas at 7th day 11.3% patients had infection in OA and in LA group only 2.7% patients had infection. Infection rate was less in LA group as compared to OA group. Conclusion: Laparoscopic appendectomy is associated with a statistically significant lower rate of wound infection as compared to open appendectomy. Although laparoscopic appendectomy is relatively expensive, but it is a safe and effective procedure for the removal of appendix over open appendectomy