A Comparative Study Of Laparoscopic Versus Open Appendectomy

Objective:This paper compares laparoscopic appendectomy(LA)with open appendectomy(OA)in the operation time,postoperative hospital stay time,intestinal function recovery time and postoperative complications,to explore the safety and feasibility of La in the treatment of acute appendicitis,and to provide guidance for the selection of clinical acute appendicitis。methods:From March 2018 to November 2019,the clinical data of 60 patients undergoing acute appendicitis surgery in the Affiliated Hospital of Jining Medical College were analyzed retrospectively.According to the operation method,the patients were divided into laparoscopic appendectomy group(LA group,n=30)and open appendectomy group(OA group,n=30).The follow-up period was 8-14 months.The data of the two groups were collected,including sex,age,BMI,preoperative leukocyte value,preoperative neutrophil value,operation time,intraoperative bleeding volume,total postoperative complications,incision infection rate,abdominal infection rate,out of bed activity time,hospitalization time,hospitalization expenses(before medical insurance reimbursement)and other indicators.SPSS 22.0 statistical software(SPSS Inc,Chicago,USA)was used for statistical analysis.The measurement data were expressed as mean±standard deviation(x±s),t-test andχ~2 test were used for the measurement data.P<0.05 indicated that the difference was statistically significant.Results:1.The patients in La group and OA group were compared in age,gender,BMI,preoperative white blood cell value,preoperative neutrophil value,preoperative pain score,intraoperative bleeding volume,operation time,drainage tube retention rate,postoperative intestinal function recovery time,postoperative total complication rate,abdominal cavity infection rate,incision infection rate,abdominal cavity bleeding rate and hospitalization time,There was no significant difference(P>0.05).2.The pain score of La group was lower than that of OA 4hours after operation,the difference was statistically significant(P<0.05).3.The time of getting out of bed activity in La group was earlier than that in OA group(P<0.05).4.The cost of hospitalization in La group was higher than that in OA group(P<0.05).Conclusion:1.Laparoscopic appendectomy and open appendectomy are safe and feasible for the treatment of appendicitis.2.Compared with open appendectomy,laparoscopic appendectomy has the advantages of less postoperative pain and earlier time to get out of bed;however,due to the expensive endoscopic equipment and other factors,the cost of hospitalization for laparoscopic appendectomy is higher.3.In clinical practice,we need to consider laparoscopic appendectomy from the perspective of patients’actual interests,combined with the therapeutic effect and the clinical skills of the operator.If we fail to master the endoscopic operation and the patients’economic level is poor,we cannot exclude open appendectomy.