DefinePK

Abstract

Background: Laparoscopic appendectomy is a common surgical procedure, and the choice of umbilical incision type may influence postoperative recovery. While intraumbilical (IU) and periumbilical (PU) incisions are both widely used, comparative evidence regarding their impact on hospital stay and patient outcomes remains limited. Objective: To compare the postoperative hospital stay between intraumbilical and periumbilical incisions in patients undergoing laparoscopic appendectomy. Study Design: Comparative study. Setting: Department of General Surgery, Saidu Medical College and Teaching Hospital, Swat, Pakistan. Duration of Study: July 2024 to January 2025. Methods: A total of 150 patients aged 18 years and above undergoing laparoscopic appendectomy were enrolled and randomly allocated into two groups: Group A (n = 75) received intraumbilical (IU) incisions, while Group B (n = 75) underwent periumbilical (PU) incisions. Standardized laparoscopic techniques were used across both groups. IU incisions were made vertically within the umbilicus, and PU incisions were placed curvilinearly above or below the umbilicus. Primary outcome measured was length of postoperative hospital stay. Secondary outcomes included operative time and postoperative pain scores (measured using a visual analogue scale). Statistical analysis was performed using independent sample t-tests, with p < 0.05 considered statistically significant. Results: The mean hospital stay in Group A (IU) was 5.52 ± 0.87 days, compared to 5.55 ± 0.94 days in Group B (PU) (p = 0.85). Mean operative time was 86.40 ± 3.55 minutes in Group A and 86.32 ± 3.76 minutes in Group B (p = 0.89), indicating no significant difference. Pain scores were slightly higher in Group A (3.69 ± 0.91) than in Group B (3.40 ± 0.91), reaching borderline statistical significance (p = 0.05). Conclusion: Intraumbilical and periumbilical incisions yield comparable clinical outcomes in laparoscopic appendectomy, with no significant differences in hospital stay or operative time. Although pain scores were marginally higher in the intraumbilical group, both techniques can be safely and effectively utilized based on surgeon preference and patient-specific considerations.