Study on Preoperative Predictive Factors for Difficult Laparoscopic Appendectomy

Abstract

Introduction: The surgical removal of the appendix is known as an appendectomy. Appendectomy can be done either laparoscopically or openly. It should be performed immediately otherwise it could burst and the bacteria and fecal particles within the organ can spread into the abdomen. Laparoscopy is now commonly used as patients can resume normal activity in less time than with open appendectomy. Patients had a better cosmetic outcome and significantly less postoperative discomfort.

Study Objectives: We attempted to identify predictors of difficult appendectomy using history and clinical examinations, preoperative laboratory data, ultrasonography findings, and intraoperative findings in this study.

Materials and Methods: The research was carried out at Agra's Sarojini Naidu Medical College.

The study included all patients who underwent laparoscopic appendectomy between January 1st, 2016 and June 30th, 2017.

A detailed Performa was created to record patient history, physical examination, laboratory parameters, ultrasonography (USG) findings, and intra-operative details.

A difficult appendectomy was defined as a laparoscopic appendectomy that took more than 120 minutes and was converted to an open surgery due to difficulty in surgery rather than complications. Severe adhesion was considered a case of difficult appendectomy.

Results: We discovered thatthe difficult laparoscopic appendectomy can be predicted preoperatively based on age > 60 years, history of previous lower abdominal surgery, time of onset to surgery > 24 hours, acute appendicitis and periappendicular collection.

Conclusion: There are few reports determining the predictors of difficult appendectomy, and more research is needed to establish them.