Comparing the Intraumbilical and Periumbilical Incision in Laparoscopic Appendectomy

Abstract

Objective: To compare outcomes of periumbilical incision and intraumbilical incision in patients of laparoscopic appendectomy

Study Design: Randomized controlled trial

Place and Duration of Study: This study was conducted at the Surgical department of Nishtar Hospital, Multan from August 2021 to July 2022.

Materials and Methods: A total of 200 patients who were admitted for elective or emergency laparoscopic appendectomy were enrolled in study. All included patients categorized into two groups (I and P) by lottery method. Group I patients who were operated with periumbilical incision method and Group P were operated with intraumbilical incision method. Main variables of study were duration of surgery, hospital stay, VAS score, and analgesia requirement and wound infection. SPSS version 24 was used for data analysis.

Results: The average operative time of I and P groups was 85.33±4.22 minutes and 85.38±4.01 minutes, respectively (p=0.922). The average length of hospital stay of I and P group was 6.17±1.84 days and 6.34±1.91 days, respectively (p=0.531). The mean morphine equivalent of I and P was 4.23±1.26 mg and 4.16±1.33 mg, respectively (p=0.705). Further, visual analogue scale of I and P group was 4.39±0.86 and 4.56±0.82 respectively (p=0.165). Wound infection in I group was 13.9% and 11.8% in P group, (p=0.655). Hernia in I group was 6.1% and 7.1% in P group (p=0.783). Further, internal organ injury in I group was 8.7% and 9.4% in P group, (p=0.861).

Conclusion: No statistically significant difference between both techniques regarding duration of surgery and hospital stay, pain score and analgesia requirement but periumbilical incision technique is associated with more incidence of wound infection as compare to intraumbilical incision group.