Mini Laparoscopic Appendectomy versus Conventional Laparoscopic Appendectomy: a One-Year Randomized Control Trial at KLE Dr. Prabhakar Kore hospital and MRC, Belgaum

Abstract

BACKGROUND AND OBJECTIVES -- Appendicitis being the commonest condition in surgical population, comes with an increasing mortality rate in untreated, misdiagnosed cases. With the latest advances in the field of laparoscopy, use of minilaparoscopy aids in diagnosis and treatment, thus reducing overall mortality and morbidity in such cases. The present study was taken up to compare better cosmetic and pain outcomes in patients undergoing minilaparoscopic appendectomy versus those undergoing conventional laparoscopic appendectomy. MATERIALS AND METHODS – A one year randomized control trial was done between January 2018 and December 2018. Patients who were diagnosed with chronic, recurrent appendicitis and chronic pain in abdomen were included in this study. Group 1 had 30 patients who underwent conventional laparoscopic appendectomy and Group 2 had 30 patients who underwent minilaparoscopic appendectomy. Pain scores in both groups was calculated with visual analogue scale at different time interval. Scar assessment in both groups was done using patient and observer scar assessment scale at different time interval. Statistical analysis was done to determine the cosmetic and pain outcome in both groups. RESULTS – In our study population it was found that patients with chronic appendicitis were maximum. Comparison of pain scores in both groups revealed significant results on POD 1 and DOD by Mann-Whitney U Test. The cosmetic outcome was found to be good in both groups. Group 2 showed consistently significant (0.0995) cosmetic outcomes throughout the study period when compared to group 1 by dependent t test. This study showed a positive correlation (0.0001) between both the groups for scar assessment by Kappa method. INTERPRETATION AND CONCLUSION – The study shows that minilaparoscopy appendectomy shows better cosmetic and pain outcomes in comparison to conventional laparoscopic appendectomy. The procedure of minilaparoscopic appendectomy comes with a few drawbacks in terms of difficult specimen retrieval and limitation of study subjects. Further studies on a larger population are required to evaluate and validate this correlation.