OUTCOMES OF OPEN AND LAPAROSCOPIC APPENDECTOMY IN MARDAN MEDICAL COMPLEX, MTI MARDAN

Abstract

Acute appendicitis represents a common emergency surgical condition worldwide. Appendectomy, performed either through open or laparoscopic techniques, remains the gold standard treatment. Although laparoscopic appendectomy is increasingly favored due to its minimally invasive nature, its advantages must be weighed against the longer anaesthesia duration and increased resource requirements, particularly in settings with limited resources. Study Design: Comparative Cross-Sectional Study. Department of Surgery, Mardan Medical Complex, MTI Mardan, Khyber Pakhtunkhwa, Pakistan. Study duration: From 11 February 2026 to 11 July 2026. Sixty patients aged 18 to 60 years with acute appendicitis who underwent appendectomy were included in the study. Allocation to open appendectomy (n=20) or laparoscopic appendectomy (n=40) was determined by clinical judgment, patient preference, and the operating surgeon's available resources. The primary outcomes assessed were anaesthesia duration, hospital length of stay, time to tolerance of oral intake, and postoperative analgesic requirement. Data were analyzed using IBM SPSS (version 26). Independent-samples t-tests were used for continuous variables, while Chi-Square or Fisher's exact tests were applied to categorical variables. Statistical significance was set at p < 0.05. The mean age of patients was 30.10 ± 7.22 years. The laparoscopic group had a significantly longer anaesthesia duration compared to the open group (77.95 ± 10.81 minutes versus 65.30 ± 7.18 minutes; p < 0.001). Conversely, laparoscopic appendectomy was associated with a shorter hospital stay (1.77 ± 0.46 days versus 3.67 ± 0.61 days; p < 0.001), earlier tolerance of oral intake (15.51 ± 3.98 hours versus 27.87 ± 5.57 hours; p < 0.001), and a lower postoperative analgesic requirement (30.0% versus 70.0%; p = 0.003). Although laparoscopic appendectomy is associated with a longer anaesthesia duration compared to open appendectomy, it confers advantages in early postoperative recovery, including shorter hospital stay, earlier oral intake, and reduced analgesic requirement. In institutions with adequate expertise and resources, laparoscopic appendectomy should be considered the preferred initial surgical treatment for uncomplicated acute appendicitis. However, these findings may not be generalizable to all patient populations.