Comparative Study of Open and Laparoscopic Appendectomy with Complications in Government and Private Sector Hospitals

Abstract

Background: Patients face a 6% lifetime probability of undergoing appendectomy as an emergency surgical treatment. The surgical treatment methods known as Open Appendectomy (OA) and Laparoscopic Appendectomy (LA) represent the standard approaches for clinical use but each brings specific benefits and restrictions. Significant progress has been made but additional comparative studies are necessary to assess the treatment results together with surgical complications and recovery in different hospital facilities. The research examines outcomes between Open Appendectomy (OA) and Laparoscopic Appendectomy (LA) across government institutions along with private healthcare facilities.

Objectives: This project examines the clinical results between OA and LA through evaluations about procedural difficulties alongside pain intensity levels and treatment duration measurements. The secondary analysis measures both surgical operation duration and patients' clinical course by charting hospital stay duration and activity restoration period and adopting patient-based results evaluation. This evaluation seeks to discover whether organizational sector impacts patient results from government sectors compared to private institutions.

Methods: This prospective comparative research took place between District Headquarter Hospital and Sandhu Medicare Hospital in Toba Tek Singh, Pakistan. The researcher enrolled 108 appendectomy patients aged between 18 and 50 through random sampling for the study. Patients were divided into two groups based on the surgical approach: OA (n=54) and LA (n=54). A structured questionnaire gathered data for demographic information alongside pre-operative and post-operative metrics and duration of surgery and complications from all participants. The researchers used SPSS software version 24 to run their statistical analysis.  

Results: Patients within the OA group presented with a mean age of 44.20 years while patients in the LA group maintained a mean age of 44.19 years. Stone operations showed higher male participation than female (62.96% in OA and 61.11% in LA). The duration of surgical procedures measured at 89.22 ± 15.48 minutes in OA and 88.65 ± 18.64 minutes in LA with no significant difference comparison (p=0.8621). The length of hospital stay was comparable between the patients having Open Appendectomy (OA) who spent 5.31 ± 1.04 days (p=0.2364) and patients having Laparoscopic Appendectomy (LA) who stayed 5.56 ± 1.06 days. The incidence of postoperative wound infection reached 37.04% in patients receiving open appendectomy whereas the patients undergoing laparoscopic appendectomy showed no infections (p<0.05). A greater percentage of patients received general anesthesia during Open Appendectomy (54%) compared to Laparoscopic Appendectomy (46%) representation (p=0.0101). Alternative methods for postoperative pain control revealed equivalent results between groups according to assessments of pain scores and administered analgesic dose measurements. Conclusion: The surgical procedure Laparoscopic Appendectomy performed better after operations due to its decreased wound infections and equal recuperation results which established it as a safer choice than Open Appendectomy. The study reveals that patient outcomes differ significantly between government facilities and private hospitals pointing to a need for common operating standards. The study establishes that surgical methods should adapt to match patient characteristics along with facility operational capabilities.