Understanding Techniques, Risks, and Recovery for Enhanced Patient Care of Laparoscopic Appendectomy

Jawad Ahmad; Imtiaz Ali; Haseeb Akhtar; Shahab  Ud Din Awan; Usman Khan; Furqan Ijaz

doi:10.62497/IRABCS.2024.55

Authors

Jawad Ahmad Northwest School of Medicine, KMU, Peshawar, Pakistan Author https://orcid.org/0009-0007-2787-7055
Imtiaz Ali Saidu Medical College, Swat, Pakistan Author
Haseeb Akhtar Northwest School of Medicine, KMU, Peshawar, Pakistan Author https://orcid.org/0009-0006-7793-8285
Shahab Ud Din Awan MBBS, Rehman Medical College, Peshawar, Pakistan Author https://orcid.org/0009-0008-7078-4185
Usman Khan Khyber Medical University Institute of Medical Sciences, Kohat, Pakistan Author https://orcid.org/0009-0002-1414-4382
Furqan Ijaz Khyber Medical University Institute of Medical Sciences, Kohat Author https://orcid.org/0009-0003-3201-1388

DOI:

https://doi.org/10.62497/IRABCS.2024.55

Keywords:

laparoscopic appendectomy, acute appendicitis, surgical technique, complications, recovery outcomes

Abstract

Introduction: Because laparoscopic appendectomy is a less intrusive procedure with good results, it has become the accepted surgical treatment for acute appendicitis. In order to improve patient care, this study sought to thoroughly examine the methods, related hazards, and recuperation times of laparoscopic appendectomy.

Methodology: A retrospective cohort study comprising 87 patients who had laparoscopic appendectomy between June 2023 and May 2024 was carried out at District Headquarters (DHQ) Hospital Kohat. Patient demographics, surgery specifics, problems, and recovery results were all recorded. To assess the data, statistical analysis such as t-tests and chi-square tests were carried out.

Results: The study population's mean age was 34.5 years, and its male to female ratio was slightly greater (57.5%). The average operating duration was 65.2 minutes, and in 13.8% and 39.1% of cases, respectively, differences in surgical technique—such as the use of SILS and advanced energy devices—were noted. The incidence of complications was minimal, with 2.3% of patients experiencing intraoperative injuries, 8.0% experiencing postoperative infections, and 4.6% developing abscesses. There were no discernible variations between male and female patients' recovery results or complication rates.

Conclusion: This study demonstrates that laparoscopic appendectomy is safe, effective, and has a low risk of complications and good recovery results when treating acute appendicitis. The results validate laparoscopic procedures as the gold standard surgical method. To improve surgical methods and postoperative care guidelines and eventually improve patient outcomes, further research is necessary.

Downloads

Download data is not yet available.

References

Hornor MA, Liu JY, Hu QL, Ko CY, Wick E, Maggard-Gibbons M. Surgical technical evidence review for acute appendectomy conducted for the agency for healthcare research and quality safety program for improving surgical care and recovery. Journal of the American College of Surgeons. 2018 Dec 1;227(6):605-17e2.

Robert Golub MD, Siddiqui F, Dieter Pohl MD. Laparoscopic versus open appendectomy: a metaanalysis. Journal of the American College of Surgeons. 1998 May 1;186(5):545-53.

Li X, Zhang J, Sang L, Zhang W, Chu Z, Li X, Liu Y. Laparoscopic versus conventional appendectomy-a meta-analysis of randomized controlled trials. BMC gastroenterology. 2010 Dec;10:1-8.

Pisanu A, Porceddu G, Reccia I, Saba A, Uccheddu A. Meta-analysis of studies comparing single-incision laparoscopic appendectomy and conventional multiport laparoscopic appendectomy. journal of surgical research. 2013 Aug 1;183(2):e49-59.

Katkhouda N, Mason RJ, Towfigh S, Gevorgyan A, Essani R. Laparoscopic versus open appendectomy: a prospective randomized double-blind study. Annals of surgery. 2005 Sep 1;242(3):439-50.

Bhangu A, Søreide K, Di Saverio S, Assarsson JH, Drake FT. Acute appendicitis: modern understanding of pathogenesis, diagnosis, and management. The Lancet. 2015 Sep 26;386(10000):1278-87.

Pedersen AG, Petersen OB, Wara P, Rønning H, Qvist N, Laurberg S. Randomized clinical trial of laparoscopic versus open appendicectomy. Journal of British Surgery. 2001 Feb;88(2):200-5.

Livingston EH, Woodward WA, Sarosi GA, Haley RW. Disconnect between incidence of nonperforated and perforated appendicitis: implications for pathophysiology and management. Annals of surgery. 2007 Jun 1;245(6):886-92.

Hootsmans N, Parmiter S, Connors K, Badve SB, Snyder E, Turcotte JJ, Jayaraman SS, Zahiri HR. Outcomes of an enhanced recovery after surgery (ERAS) program to limit perioperative opioid use in outpatient minimally invasive GI and hernia surgeries. Surgical Endoscopy. 2023 Sep;37(9):7192-8.

Andersson RE. The natural history and traditional management of appendicitis revisited: spontaneous resolution and predominance of prehospital perforations imply that a correct diagnosis is more important than an early diagnosis. World journal of surgery. 2007 Jan;31:86-92.

Macías AA, Finneran JJ. Regional anesthesia techniques for pain management for laparoscopic surgery: a review of the current literature. Current Pain and Headache Reports. 2022 Jan;26(1):33-42.

Hosseini SV. Comparison of laparoscopic versus open appendectomy results elderly patients: Scoping review. Eurasian Journal of Chemical, Medicinal and Petroleum Research. 2023 Jan 14;3(1):61-71.

Aziz O, Athanasiou T, Tekkis PP, Purkayastha S, Haddow J, Malinovski V, Paraskeva P, Darzi A. Laparoscopic versus open appendectomy in children: a meta-analysis. Annals of surgery. 2006 Jan 1;243(1):17-27.

Gerges FJ, Kanazi GE, Jabbour-Khoury SI. Anesthesia for laparoscopy: a review. Journal of clinical anesthesia. 2006 Feb 1;18(1):67-78.

Gulanick M, Myers JL. Nursing care plans: Diagnoses, interventions, and outcomes. Elsevier Health Sciences; 2011.

Childers CP, Maggard-Gibbons M. Understanding costs of care in the operating room. JAMA surgery. 2018 Apr 1;153(4):e176233-.

White PF, Kehlet H, Neal JM, Schricker T, Carr DB, Carli F, Fast-Track Surgery Study Group. The role of the anesthesiologist in fast-track surgery: from multimodal analgesia to perioperative medical care. Anesthesia & Analgesia. 2007 Jun 1;104(6):1380-96.

Rollins KE, Varadhan KK, Neal KR, Lobo DN. Antibiotics versus appendicectomy for the treatment of uncomplicated acute appendicitis: an updated meta‐analysis of randomised controlled trials. World journal of surgery. 2016 Oct;40(10):2305-18.

Zorron R, Carvalho G. Laparoscopy and laparotomy. Yamada's Textbook of Gastroenterology. 2015 Nov 27:2693-702.

Moparthi KP, Javed H, Kumari M, Pavani P, Paladini A, Saleem A, Ram R, Varrassi G. Acute Care Surgery: Navigating Recent Developments, Protocols, and Challenges in the Comprehensive Management of Surgical Emergencies. Cureus. 2024 Jan 14;16(1).