Gundavda Manit K, Bhandarwar Ajay H
Department of Surgery, Sir J.J. Group of Hospitals, Mumbai, Maharastra, India.
Indian J Med Sci. 2012 May-Jun;66(5-6):99-115.
Comparative Study of Laparoscopic (LA) versus Open Appendicectomy (OA) as a Cross sectional hospital based study for evaluation of: Postoperative quality of life Postoperative painAmount of Narcotics/Analgesics usedHospital stayTime to full recovery
This underdeveloped residuum of the caecum has no known function and is commonly termed as a 'vestigial' organ, yet diseases of the appendix loom large in surgical practice; and appendicitis continues to be the most common acute abdominal condition that requires immediate surgical treatment.
Study to be carried out over a period of two months included patient diagnosed with appendicitis and admitted to surgery ward at Sir J.J. Group of Hospitals, Mumbai, India and St. George Hospital, Mumbai, India and willing to be enrolled in the study.Demographic data, clinical features, investigations, Technique, reintroduction of diet, postoperative pain, use of analgesia, hospital stay were documented and outcome recorded in a predesigned case record form. Return to normal activity and work was determined by questioning during postoperative clinic.
Proved that laparoscopic procedures cause less post-operative pain than their conventional counterpartsAnalgesic requirement for post operative analgesia was significantly less in LA (mean 4 inj. doses) compared to the OA (mean 5.9 inj. doses) Hospital stay was less for LA (2.23 days) than OA (3.4 days) Full recovery on the basis of return to normal activity was earlier in LA (6.53 days) as compared to OA (8.7 days).
LA holds a promising prospect and may replace OA in the near future as the method of choice for effective and qualitative clinical management of appendicitis in emergency and in elective set up.
腹腔镜阑尾切除术（LA）与开腹阑尾切除术（OA）的对比研究——一项基于医院横断面的研究，用于评估：术后生活质量、术后疼痛、麻醉剂/镇痛药使用量、住院时间、完全康复时间
盲肠的这一未发育残留物没有已知功能，通常被称为“退化”器官，但阑尾疾病在外科实践中却很突出；阑尾炎仍然是最常见的需要立即手术治疗的急性腹部疾病。
为期两个月的研究纳入了在印度孟买J.J.医院集团和印度孟买圣乔治医院被诊断为阑尾炎并入住外科病房且愿意参与研究 的患者。记录人口统计学数据、临床特征、检查、手术技术、饮食恢复情况、术后疼痛、镇痛药物使用情况、住院时间，并将结果记录在预先设计的病例记录表中。通过术后门诊询问确定恢复正常活动和工作的情况。
证明腹腔镜手术比传统手术引起的术后疼痛更少。与开腹阑尾切除术（平均5.9次注射剂量）相比，腹腔镜阑尾切除术术后镇痛的镇痛药物需求量显著更少（平均4次注射剂量）。腹腔镜阑尾切除术的住院时间（2.23天）比开腹阑尾切除术（3.4天）更短。基于恢复正常活动，腹腔镜阑尾切除术（6.53天）比开腹阑尾切除术（8.7天）恢复得更早。
腹腔镜阑尾切除术前景广阔，在不久的将来可能会取代开腹阑尾切除术，成为急诊和择期阑尾炎有效和高质量临床管理的首选方法。
