เปรียบเทียบผลลัพธ์การผ่าตัดไส้ติ่งแบบส่องกล้องกับการผ่าตัดไส้ติ่งแบบเปิด ในโรงพยาบาลอู่ทอง จังหวัดสุพรรณบุรี

Nattawut Kalapong

Authors

Nattawut Kalapong U-thong Hospital

Keywords:

Acute appendicitis, Laparoscopic appendectomy: LA, Open appendectomy: OA, Clinical outcomes, U-thong Hospital

Abstract

Objective: Acute appendicitis is a leading cause of acute abdominal pain requiring emergency surgery. While laparoscopic appendectomy (LA) has gained popularity due to its perceived benefits in recovery, evidence comparing LA and open appendectomy (OA) within the context of community hospitals remains limited. This study aimed to compare the clinical outcomes and economic aspects between LA and OA at U-thong Hospital. Data regarding clinical outcomes (operative time, blood loss, time to first meal, complications, and length of stay) and economic indicators (relative weight: RW and total medical income) were collected.

Methods: A retrospective cohort study was conducted on patients diagnosed with acute appendicitis who underwent appendectomy at U-thong Hospital between July 2023 and July 2025. Statistical analysis was performed using chi-square test, independent t test, and Mann-Whitney U test, with significance set at p < .05.

Results: A total of 140 patients were included, consisting of 64 patients in the OA group and 76 patients in the LA group. The baseline characteristics were comparable between both groups; the LA group had significantly higher body weight and body mass index (BMI) than the OA group (p < .05). In terms of clinical outcomes, there were no statistically significant differences between the two groups in blood loss, time to initiation of oral intake after surgery, complication rate, or length of hospital stay. However, the operative time in the LA group was significantly longer than that in the OA group (p < .05). From an economic perspective, LA was associated with higher relative weight (RW) and higher total medical income than the OA procedure.

Conclusion: Laparoscopic appendectomy is a safe and effective alternative for treating acute appendicitis in a community hospital setting, particularly for patients with high BMI. In addition, in terms of revenue, the LA procedure generated higher income than OA; however, cost and operative time should also be considered in the context of each hospital, particularly community hospitals.

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กรรณเอก หนุนแหลมทอง. การศึกษาความเจ็บปวดหลังผ่าตัดและผลการรักษาไส้ติ่งอักเสบเปรียบเทียบระหว่างผ่าตัดแบบส่องกล้องและการผ่าตัดแบบเปิดท้อง [อินเทอร์เน็ต]. 2566 [เข้าถึงเมื่อ 14 สิงหาคม 2566]. เข้าถึงได้จาก: URL: https://bkpho.moph.go.th/ssjweb/bkresearch/require/files/post-doc/20231221153302