J Med Assoc Thai 2018; 101 (7):987-91

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Single Port Laparoscopy Appendectomy versus Open Appendectomy, Prospective Randomized Study
Teerawiwatchai C Mail, Imsanguanchai M , Ajjimarangsi S

Objective: To evaluate complication after single port laparoscopic appendectomy [SPLA] compare with open appendectomy [OA] in patients diagnosed acute appendicitis.

Materials and Methods: The present study enrolled 172 patients diagnosed as acute appendicitis at Hatyai Hospital in Songkhla, Thailand. All studied patients were randomized using numbered envelopes (block of four) in OA and SPLA by residents. The primary outcome was overall 30 days postoperative complications. Twelve patients diagnosed as ruptured appendicitis during operation were excluded from the study.

Results: There were no significant differences between age, gender, body mass index, preoperative leukocyte count, pathological report and percentage of neutrophil. The overall 30-day complication was similar in both groups. The mean operative time for SPLA group was 37.9 minutes compared with 44.4 minutes for OA group (p = 0.005). Numeric Rating Scale of pain score (NRS) at 4th hour in SPLA group was less than OA group significantly (p = 0.015), while NRS at 8, 12 and 24 hours postoperative were not different between both groups. SPLA shows less pain than OA at 4 hours due to less tissue damage but no difference later. There was no significant difference in length of hospital stay, morphine consumption and time to regular diet in both groups. Most of the patients preferred wound from SPLA than wound from OA.

Conclusion: The single port laparoscopic appendectomy shorter operative time and less pain with similar postoperative complication compared with open appendectomy. From this study, single port laparoscopic appendectomy is safe procedure for treatment acute appendicitis

Keywords: Single port laparoscopic appendectomy, Open appendectomy, Acute appendicitis


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