Laparoscopy versus Laparotomy for Management of Complicated Acute Appendicitis: Randomized Clinical Trial | ||
| Zagazig University Medical Journal | ||
| Articles in Press, Accepted Manuscript, Available Online from 02 November 2025 | ||
| Document Type: Original Article | ||
| DOI: 10.21608/zumj.2025.429141.4231 | ||
| Authors | ||
| Ahmed M. Mahgoub1; Abdalla Ahmed Mohamed Ahmed* 2; Hatem Mohammad3; Mohamed Abdalla Zaitoun4; Ahmed Shafik Mohamed El hefnawy4 | ||
| 1Lecturer of General Surgery, Faculty of Medicine, Zagazig University, Egypt | ||
| 2Department of General Surgery, Faculty of Medicine, Zagazig University, Egypt | ||
| 3Professor of General Surgery, Faculty of Medicine, Zagazig University, Egypt | ||
| 4Assistant Professor of General Surgery, Faculty of Medicine, Zagazig University, Egypt | ||
| Abstract | ||
| Background: Acute appendicitis is a common surgical emergency. Laparoscopic appendectomy (LA) has been increasingly adopted for complicated cases, but its outcomes compared to open appendectomy (OA) remain debated. In patients with complex acute appendicitis, the study sought to compare the clinical results of laparoscopic and open appendectomy. Methods: This randomized clinical trial included 36 patients with complicated appendicitis, randomized into OA (n=18) and LA (n=18) groups. Demographics, clinical presentation, operative findings, laboratory markers (TLC, CRP), postoperative outcomes, and complications were recorded. Operative time, hospital stay, time to oral intake, drain status, and return to work were analyzed. Results: There were no significant differences in age, sex, presenting symptoms, or intraoperative findings between the groups. Operative time was significantly shorter in LA (46.94±6.45 min) than OA (57.78 ± 18.8 min; p=0.03). Hospital stay (2.5 ± 0.71 vs. 3.56 ± 1.25 days; p<0.001) and return to work (10.94 ± 2.51vs. 15.5 ± 1.92 days; p<0.001) were significantly faster in LA. Overall postoperative complications were significantly lower in LA (11.1%) compared to OA (50%; p=0.01), including wound infection, wound dehiscence, paralytic ileus, and intra-abdominal collections. Laboratory markers (TLC, CRP) decreased similarly in both groups postoperatively. Conclusion: Laparoscopic appendectomy is safe and effective for complicated appendicitis, offering shorter operative time, reduced morbidity, Compared to an open appendectomy, there is an earlier oral intake, a shorter hospital stay, and a quicker return to routine activities. Surgeon expertise and adherence to proper intraoperative precautions are essential for optimal outcomes. | ||
| Keywords | ||
| Laparoscopic appendectomy; Open appendectomy; Complicated appendicitis; Postoperative complications | ||
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