الفهرس 
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Abstract
Acute appendicitis can be considered the signature disease encountered by the general surgeon. It is the most frequent abdominal diagnosis treated by surgeons.There have been numerous previous studies comparing open appendectomy with laparoscopic appendectomy. Although most of these have concluded that the laparoscopic technique is as good as OA, there has been considerable controversy as to whether LA is superior to OA or not.
The aim of this study is to compare between laparoscopic and open appendectomy regarding operative time, postoperative pain, complications, time to return to normal activities and cosmesis. We included 60consecutive patients with acute appendicitis. The patients were randomly allocated into 2 groups; 30 patients for laparoscopic appendectomy group and 30 patients for open appendectomy group. LA was done with the help of three trocar/ cannulae creating pneumoperitoneum with CO2 where as OA was performed by McBurney,s incision.
After analyzing the data using chi square test and student’s t test we noticed that, there is significant difference between the two procedures with laparoscopic appendectomy being better in respect to most of the terms.
The mean score for duration of time of surgery was 36.17±12.25 minutes in laparoscopic group and 17.5 ±5.211 minutes in open group.
In the study, the mean post op pain score was recorded at the end of 24 hours for laparoscopic appendectomy is 1.37±0.49 and for open appendectomy is 3.27±0.828.
In the study, the mean hospital stay score was 1.77 ±0.728 days in the laparoscopic group and 7.73 ±1.363 days in the open group.
In the study, the mean score return to work was 9.6 days in laparoscopic and 17.67 days in the open group.
As regard postoperative complications:
In the study, 6 patients in laparoscopic group (20%) and 16 patients in open group (53.3%) have post op vomiting.
In the study, 8 patients in open group (26.7%) and 4 patients in laparoscopicgroup (13.3%) have post op fever
In the study, 8 patients in open group (26.7%) and 1 patients in laparoscopic group(3.3%) have post op wound infection.
In the laparoscopic group, 26 (86.7%) patients were satisfied with cosmetic benefit, 4 (13.3%) patients were equivocally satisfied, 0 patients were unsatisfied.
In the open group, 15(50%) patients were satisfied, 8 (26.7%) were equivocally satisfied, 7 (23.3%) patients were un satisfied with cosmetic benefit.
The study show that laparoscopic group had better cosmetic results.
LA is safe and has major benefits like less postoperative time, less postoperative pain, decreased wound infection, short hospital stay, early return to work and abetter cosmetic scar than OA.
Conclusion:
Laparoscopic appendectomy is safe and feasible.Despite that the operating time for laparoscopic appendectomy is still longer than that for open appendectomy, Laparoscopic approach had several advantages over open appendectomy in that, It has less incidence of wound infection, shorter hospital stay, less incidence of severe post operative pain and faster return of patients to normal activities and more satisfying cosmetic results. We must convert laparoscopic procedure to open surgery when indicated for the safety of the patients.