EVALUATION OF THE OUTCOMES POST OPEN APPENDECTOMY

Abstract

Introduction: Appendectomy, a common surgical procedure for appendicitis with a 6% lifetime risk, primarily involves open appendectomy (OA) with an 11% morbidity rate and 0.3% mortality rate. McBurney's 1894 technique remains a standard, marking a century of practice. Acute appendicitis, with a 9-10% lifetime risk, most commonly affects individuals aged 10-20. Charles McBurney's 1895 report revolutionized surgical care, introducing lateral incisions as an alternative to midline laparotomy. Today, both laparoscopic and open appendectomy approaches exist, with surgery remaining the mainstay despite antibiotic therapy advancements. The Gridiron Incision is utilized in open appendectomy.

Aim and objectives: To improve surgical understanding, and evaluate post-open appendectomy complications, recovery, and efficacy.

Method: This one-year prospective study focused on appendicitis patients admitted to the hospital, excluding pregnant women and those with critical conditions, coagulation issues, cirrhosis, chronic diseases, or mental health problems. Data from 70 eligible patients undergoing open appendectomy were collected, covering demographics, medical history, lab results, surgical details, postoperative recovery, and complications. The study employed a specific protocol, including antibiotics, McBurney incision, peritoneal inspection, meticulous dissection, and histopathological analysis. Patients were discharged upon meeting criteria such as pain relief, bowel sounds, and consistent dietary intake. The research observed gender-specific parameters and complications, emphasizing the importance of clear inclusion and exclusion criteria for meaningful results.

Result: The study on open appendectomy procedures reveals notable gender differences in postoperative outcomes. Males exhibit significantly shorter operative times (29.40 ± 10.50 minutes) than females (53.8 ± 13.9 minutes). Additionally, a higher percentage of women report bowel movements (60.00%) and an earlier return to regular eating schedules (40.00%) on the first postoperative day (POD) compared to men. Gender disparities extend to analgesic usage, with men requiring more doses of parenteral analgesics. The study also identifies various postoperative complications, including vomiting, paralytic ileus, and wound infection as minor problems, and highlights major issues such as wound dehiscence, intra-abdominal abscess, and hemoperitoneum. The findings suggest potential gender-related variations in healing processes following open appendectomy, emphasizing the need for tailored postoperative care and monitoring to enhance recovery outcomes with minimal complications.

Conclusion: This study concluded that compared to open appendectomy provided a number of benefits, such as a shorter recovery time, reduced need for postoperative pain medication, quicker return to work, fewer wound infections, and somewhat higher hospital costs.

Keywords: Appendicitis, Laparoscopic appendectomy, lateral incisions, antibiotics