Single Port Laparoscopy Appendectomy versus Open Appendectomy, Prospective Randomized Study
Chusaeng Teerawiwatchai MD 1 , Manasawin Imsanguanchai MD 1 , SasithonAjjimarangsi MD 1
Affiliation : 1 Department of general surgery, Hatyai Hospital, Hat Yai, Songkhla, Thailand
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
4 th 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
