OPEN VERSUS LAPAROSCOPIC APPENDECTOMY: A COMPARATIVE STUDY

Background: Acute appendicitis is one of the most frequent surgical emergencies globally, with appendectomy remaining the definitive treatment. Advances in minimally invasive surgery have positioned laparoscopic appendectomy as an alternative to the conventional open procedure, offering the potential for reduced morbidity, faster recovery, and improved patient comfort. However, open appendectomy continues to be practiced extensively, particularly in resource-limited settings. Comparative evaluation of both techniques is necessary to guide evidence-based surgical decision-making. Objective: The objective of this study was to compare intraoperative and postoperative outcomes between open and laparoscopic appendectomy in patients with acute, non-perforated appendicitis. Methods: An analytical cross-sectional study was conducted at General Hospital Lahore over four months, from April to July 2024. A total of 200 patients were enrolled and divided equally into two groups: Group A underwent open appendectomy and Group B underwent laparoscopic appendectomy. Intraoperative outcomes included operative time and blood loss, while postoperative outcomes included pain scores at the fourth hour and incidence of intra-abdominal abscess within three weeks of follow-up. Pain was measured using the visual analogue scale (VAS), blood loss was recorded in milliliters, and suspected abscesses were confirmed via ultrasound. Data were analyzed using SPSS version 23, with a p-value of <0.05 considered significant. Results: The mean operative time was shorter in the open appendectomy group, while laparoscopic appendectomy resulted in significantly lower intraoperative bleeding (25.6 ± 36.2 mL vs. 6.9 ± 6.5 mL). Postoperative pain scores were higher in the open group (mean VAS 6.5 ± 0.87) compared to the laparoscopic group (mean VAS 4.5 ± 0.87). Intra-abdominal abscess formation occurred in 3 patients (3%) in the open group and 5 patients (5%) in the laparoscopic group. Conclusion: Laparoscopic appendectomy demonstrated superiority in terms of reduced bleeding and postoperative pain, whereas open appendectomy showed advantages of shorter operative time and fewer abscesses. Surgical decision-making should remain patient-centered, taking into account individual physiology, disease complexity, and institutional resources.