EUROPEAN JOURNAL OF
PHARMACEUTICAL AND MEDICAL RESEARCH

( An ISO 9001:2015 Certified International Journal )

An International Peer Reviewed Journal for Pharmaceutical, Medical & Biological Sciences

An Official Publication of Society for Advance Healthcare Research (Reg. No. : 01/01/01/31674/16)

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ISSN 2394-3211

Impact Factor: 7.065

ICV - 79.57

Abstract

EVALUATION OF POST OPERATIVE PAIN AND COSMETIC OUTCOME BETWEEN SINGLE INCISION LAPAROSCOPIC APPENDECTOMY AND CONVENTIONAL THREE PORT LAPAROSCOPIC APPENDECTOMY: A RANDOMIZED CLINICAL TRIAL

Dr. Rameshkumar Pandey*, Bhupendra Mehra and Robert Keisham

ABSTRACT

BACKGROUND: Laparoscopic appendectomy is now considered the gold standard for appendicitis, even in complicated appendicitis. The recent trend of Trans-umbilical single incision laparoscopic appendectomy (SILA) is a further improvement of the conventional three port laparoscopic appendectomy (CLA). In this study we compared the postoperative outcomes of SILA with CLA in a tertiary care hospital located in central India. METHODS: In this randomized controlled trial, 60 patients of appendicitis were operated between Dec 2013 and Oct 2015. 30 patients underwent SILA and the remaining 30 underwent CLA. From the two groups, we compared the postoperative pain and the cosmetic outcomes between the two procedures. Post operative pain scores were recorded on the visual analogue scale (VAS) 24 hours and 7 days after surgery. Cosmetic outcome was evaluated using a body image questionnaire consisting of a body image score and a cosmetic score on the 7th and 30th postoperative days. RESULT: There were no significant difference in the post operative pain between SILA group and CLA group 24 hours after surgery (VAS 3.13± 0.34 v/s 3.10±0.30, p=0.69) and 7 days after surgery (VAS 2.03±0.12 v/s 2±0.00, p=0.321). However, the cosmetic outcome was in favor of the SILA group over the CLA group on both postoperative day 7 [(Body image score 5.13±0.43 v/s 5.93±0.58, p<0.01), (Cosmetic score 22.20±1.24 v/s 21±0.26, p<0.01)] and on follow up after 30 days [(Body image score 5.00±0.00 v/s 5.83±0.64, p<0.01), (Cosmetic score 23.53±0.73 v/s 21.10±0.71, p<0.01)]. CONCLUSION: There is a distinct cosmetic advantage of SILA over CLA. There is no statistical difference in pain scores in immediate postoperative period or later.

Keywords: Appendicitis, Laparoscopic appendicectomy, Single incision, SILS port, postoperative pain.

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