Determination of the Outcomes of Laparoscopic Appendecectomies at the University Teaching Hospital, Zambia

  • Rajesh Parekh University Teaching Hospital, Department of Surgery, P/B RW1X, Lusaka, Zambia.
  • Hanna Habib University Teaching Hospital, Department of Surgery, P/B RW1X, Lusaka, Zambia.
Keywords: Laparoscopic Appendicectomy, Post Operative outcomes, University Teaching Hospital, Zambia.

Abstract

Introduction: Several studies have demonstrated the superiority of Laparoscopic appendicectomy in managing acute appendicitis. Acute appendicitis has been managed solely by open appendicectomy at the University Teaching Hospital (UTH). This was the first study that looked at the management of acute appendicitis by laparoscopy at UTH. This study aimed to determine the outcomes of laparoscopic appendicectomy at UTH. Materials and Methods: This was a prospective cohort study that included patients that were diagnosed with acute uncomplicated appendicitis. All patients admitted between August 2015 to March 2016 were included in the study. Variables analyses were patient’s data (age, gender, previous surgery, WBC count, symptoms, signs, symptoms), operating time, intra\post operative complications, and length of stay. Results: A total of 9 laparoscopic appendicectomies were performed during the study period. The patients had an average age of 31.8 years and were predominantly female (70%). One case was converted to open appendicectomy and was not included in the laparoscopic data group. The mean operative time for the procedure was 75.5 min (range 50-110min). The length of stay was on average 2.3 days (range 2-3 days). The patients in the study had no complications noted during the follow-up period. No patient developed an intraabdominal abscess during the study period. Conclusion: Laparoscopic appendicectomy for uncomplicated acute appendicitis resulted in good surgical outcomes in this institution compared to the regional statistics as a reference point. It may be preferred in patients presenting with uncomplicated appendicitis or where the diagnosis is equivocal. Laparoscopic appendicectomy is recommended, especially for the young female patients in our setting.

References

1. McBurney C, 1894. The incision made in the abdominal wall in cases of appendicitis. Ann Surg, 20-38.
2. Sauerland S, Lefering R, Neugrebaver E., 2010. Laparoscopic versus open surgery for suspected appendicitis, Thecochrane collaboration: Issue 10.
3. Josloff R, Zuker K., 2001. Laparoscopic Appendicectomies. Surgical Laparoscopy, 229-235.
4. Parker RB, Thagana N, Baraza R, 2003. Experience with Laparoscopic surgery at Aga Khan Hospital, East African Medical Journal: 44-50.
5. Ray-Offer E, Okoro PE, Ggobo I, 2014. Pilot study on Laparoscopic surgery in Port Harcourt, Nigerian Journal of Surgery, volume (20): 23-25.
6. Fogli L, Brulatti M, 2002. Laparoscopic Appendicectomy for acute and recurrent Appendicitis, Journal of Laparoendoscopic Advances in surgical techniques, Issue (12): 107-110.
7. Lin HF, Wu J, Tsang L, 2006. Laparoscopic versus open appendectomy for perforated appendicitis, Journal of Gastrointestinal Surgery, Volume (10): 906-910
8. Britton J, Barr H, 1994. Endoscopic Surgery. In: Oxford textbook of surgery: oxford medical Publishers, 847-862.
9. Richard C, Frazee MD, Stephen W, Abernathy MD, Claire L, Isbell MD, Justin L, Regner MD, Randall D, Smith MD, 2016. Outpatient Laparoscopic Appendectomy: Is It Time to End the Discussion? Journal of the American College of Surgeons, Volume 222, Issue 4, April 2016, Pages 477- 480.
10. Adewale OA, Olusegun IA, Oladejo OL, 2012. Laparoscopic Appendectomy in a Nigerian Teaching Hospital, Journal of the Society of Laparoendoscopic Surgeons, 16 (4): 576-580.
11. Rajab A, Muhammad RK, Mohammad T, 2010. Laparoscopic Appendectomy for Acute Appendicitis: Is This a Feasible Option for Developing Countries? Saudi Journal for Gastroenterology: Official Journal of the Saudi Gastroenterology Association, 16(1): 25-29.
12. Mwero B, 2003. Dissertation in partial fulfilment for the degree of master of medicine (surgery ), University of Nairobi, 41.
13. Antonio B, Carla DS, Francesco F, Angelo B, Marco V, Luigi P, 2016. Laparoscopic versus open appendectomy: a retrospective cohort study assessing outcomes and cost-effectiveness, World Journal of Emergency Surgery, 11:44.
14. Rasha K, Khalid S, Mohammed K, 2017. Effects and clinical outcomes of laparoscopic appendectomy in young children with complicated appendicitis: a case series. The Egyptian Journal of Surgery 2017, Volume (36): 152–155.
15. Yau KK, Siu WT, Tang CN, Yang GP, Li MK, 2007. Laparoscopic versus open appendectomy for complicated appendicitis. J Am Coll Surg; 205: 60-65.
16. Leily ML, Rouzrokh M, Tabari AK, 2014. Laparoscopic appendectomy in complicated appendicitis of children, Ann Colorectal Res.
17. Jian CG, Feng T, Xiao‐Jun Zhou, Xiao‐Gang Wang, Shu‐Sheng Wang, Han Zhang, Wan‐Yee Lau, Tian Yang, 2015. Trends and outcomes of laparoscopic appendectomy in China: A multicenter, retrospective cohort study, Surgical practice, https://doi.org/10.1111/1744-1633.12141. SP. Jian-Guo (2015).
18. Li X, Zhang J, Sang L, Zhang W, Chu Z, Li X, Liu Y, 2010. Laparoscopic versus conventional appendectomy ‚ A meta-analysis of randomized controlled trials. BMC Gastroenterol ; 10:129.
19. Vahdad MR, Troebs R, Nissen M, Burkhardt LB, Hardwig S, Cernaianu G, 2013. Laparoscopic appendectomy for perforated appendicitis in children has complication rates comparable with those of open appendectomy, J Pediatr Surg; 48:555-561.
20. Wang X, Zhang W, Yang X, Shao J, Zhou X, Yuan J,(2009), Complicated appendicitis in children: is laparoscopic appendectomy appropriate? A comparative study with the open appendectomy in our experience. J Pediatr Surg; 44:1924-1927.
21. Jun Tashiro, Stephanie A. Einstein, Eduardo A. Perez, Steven N. Bronson, David S. Lasko, Juan E. Sola, (2016), Hospital preference of laparoscopic versus open appendectomy: Effects on outcomes in simple and complicated appendicitis,
22. Sauerland S, Lefering R, Neugebauer EA. 2007. Laparoscopic versus open surgery for suspected appendicitis. Cochrane Database Syst Rev 2007;4;CD001546.
Published
2022-01-03
How to Cite
1.
Parekh R, Habib H. Determination of the Outcomes of Laparoscopic Appendecectomies at the University Teaching Hospital, Zambia. University of Zambia Journal of Agricultural and Biomedical Sciences [Internet]. 3Jan.2022 [cited 4Jul.2022];5(3):35-3. Available from: https://journals.unza.zm/index.php/JABS/article/view/691
Section
Biomedical Sciences