Early Post-Operative Outcomes in Closure and Non-Closure of Peritoneum in Open Appendicectomy for Uncomplicated Appendicitis.

Abstract

Open appendicectomy remains a common surgical procedure for managing uncomplicated acute appendicitis. Traditionally, peritoneal closure has been performed to restore anatomical layers, but this practice has been questioned due to its potential impact on surgical duration, postoperative pain and recovery outcomes. This study aims to compare early postoperative outcomes between peritoneal closure and non-closure techniques in patients undergoing open appendicectomy. This prospective comparative study was conducted at Mymensingh Medical College Hospital, Bangladesh, from July 2021 to June 2022, including 80 patients undergoing open appendicectomy for uncomplicated acute appendicitis. Patients were divided into Group I (peritoneal closure) and Group II (peritoneal non-closure).Data were processed and analyzed using the computer software SPSS (Statistical Package for Social Sciences, version 26.0 for Windows). The probability value, p<0.05 was considered statistically significant. There was no significant difference in age, sex, BMI, or comorbidities between the groups. Most procedures used a Grid Iron incision (67.5%). Wound infection (22.5%, 17.5% respectively) and wound dehiscence (7.5%, 2.5% respectively) rates were almost similar, with no significant differences (p=0.576 and p=0.305, respectively). However, Group II had significantly lower postoperative wound pain (p<0.001), reduced analgesic requirements (p<0.001) and shorter surgery duration (p<0.001) compared to Group I, demonstrating the potential benefits of omitting peritoneal closure in appendicectomy. It is concluded that non-closure of the peritoneum at open appendicectomy for uncomplicated appendicitis appears to have no adverse effect on post-operative recovery and outcome. Leaving the peritoneum open seems to reduce the operating time and shorter hospital stays. It also decreases post-operative pain with less analgesic requirement. Hence, the practice of non-closure of peritoneum in open appendicectomy for uncomplicated appendicitis can be done safely.