Outcomes of Open Appendicectomy by Simple Ligation versus Invagination in Acute Appendicitis- A Prospective Observational Study

Abstract

Introduction: Surgical techniques in open appendicectomy has been evolving with most centers following simple ligation of appendix stump as the most preferred approach including the laparoscopic approach. Invagination of stump of the appendix is also practiced as a traditional approach. Aim: To compare and evaluate the outcomes and postoperative morbidity of simple ligation and invagination appendicectomy techniques. Materials and Methods: This was a prospective observational study conducted from October 2016 to July 2018 and included a total of 100 patients of acute appendicitis undergoing emergency open appendectomy surgery. The method of surgery of simple ligation and invagination appendectomy was allotted alternatively with 50 patients in each category. Both techniques of surgery were compared in terms of operating time, duration of hospital stay and postsurgical complications. Relevant data was collected and entered in Microsoft excel and p-value was calculated using Chi-square test. Results: A total of 100 patients were included with a mean age of 27 years. Both the groups with 50 patients each, were equivalent with age and gender distribution. It was observed that both the techniques had similar outcomes in respect to mean duration of surgery, duration of hospital stay and morbidities (p-value>0.05) with no statistically significant difference. The morbidity and the rate of postoperative complications were similar in both the groups. Conclusion: Appendicular stump management after appendectomy can be treated either by simple ligation or by invagination method, both techniques being equally effective and safe. Hence, it is surgeons preference to choose among the two techniques.

Keywords

• appendix stump
• burial of stump
• postoperative ileus
• wound infection