Bowel Obstruction Post Open Versus Laparoscopic Appendectomy

Comparative Study of Incidence of Bowel Obstruction Post Open Versus Laparoscopic Appendectomy

Acute appendicitis is one of the most common causes of acute abdominal pain requiring surgical intervention, with appendectomy being the definitive treatment . Traditionally performed through an open approach, appendectomy has evolved significantly with the advent of minimally invasive surgery. Since its introduction in the late 1980s, laparoscopic appendectomy has gained widespread acceptance and is now often preferred due to its well-documented advantages, including reduced postoperative pain, shorter hospital stay, quicker return to normal activity, and improved cosmetic outcomes . Despite these benefits, concerns remain regarding the long-term postoperative complications associated with both laparoscopic and open approaches, one of the most clinically significant being bowel obstruction

Study Overview

• Status: Completed
• Conditions: Bowel Obstruction
• Intervention / Treatment: Procedure: Open appendectomy; Procedure: Laparoscopic appendectomy

Detailed Description

Postoperative bowel obstruction, often resulting from intra-abdominal adhesions, is a common and sometimes serious complication following abdominal surgeries. The pathogenesis of these adhesions can be influenced by several factors, including the extent of tissue handling, exposure of peritoneal surfaces, the degree of inflammation presents during surgery, and the surgical technique used .

Open surgery, by its nature, involves a larger incision and greater manipulation of intra-abdominal structures, which may predispose patients to more extensive adhesion formation and, subsequently, higher rates of bowel obstruction. On the other hand, laparoscopic surgery, with its minimal access approach, is associated with less tissue trauma and reduced adhesion formation in various abdominal procedures. However, it is not entirely devoid of risk, and rare but serious complications such as internal herniation and port site adhesions can also lead to bowel obstruction in laparoscopic cases .

The clinical presentation of postoperative bowel obstruction can vary widely, ranging from mild intermittent symptoms to complete mechanical obstruction requiring urgent reoperation. Understanding the relative risk and nature of bowel obstruction following laparoscopic versus open appendectomy is essential for both surgical decision-making and informed patient counseling. Moreover, identifying differences in the timing, severity, and management outcomes of this complication between the two surgical approaches may help refine perioperative strategies to minimize patient morbidity .

While several studies have attempted to compare postoperative outcomes between laparoscopic and open appendectomy, data specifically focusing on the incidence and characteristics of bowel obstruction are less abundant and sometimes conflicting . Some retrospective reviews suggest a lower incidence of bowel obstruction following laparoscopic appendectomy, while others report no significant difference. Variations in surgical technique, patient selection, underlying pathology, and follow-up duration may all contribute to these discrepancies .

• Study Type: Interventional
• Enrollment (Actual): 50
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Egypt
  • Sohag, Egypt
    • Sohag University Hospitals

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• both genders
• confirmed diagnosis of acute appendicitis
• patients undergo laparoscopic or open appendectomy

Exclusion Criteria:

• appendectomy performed as apart of another operation
• prior history of abdominal surgery
• patients show generalized peritonitis

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Diagnostic
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Group A	Procedure: Open appendectomy; Open appendectomy For gruop A
Active Comparator: Gruop B	Procedure: Laparoscopic appendectomy; Laparoscopic appendectomy for group B

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Incidence of bowel obstruction post laparoscopic versus open appendectomy	6 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
• Operative time		: During operation (from incision to closure)
Analgesic requirement		From postoperative Day 0 through postoperative Day 7.
Postoperative pain	Postoperative pain assessed using the Visual Analog Scale (VAS; range 0-10, where 0 indicates no pain and 10 indicates the worst imaginable pain).	Postoperative Day 1.
Post operative hospital stay		From the day of surgery until hospital discharge (average of 2-5 days).

Collaborators and Investigators

• Sponsor: Sohag University
• Investigators: Study Director: osama abdlrahem oraby, professor, Sohag university

Study record dates

Study Major Dates

• Study Start (Actual): July 1, 2025
• Primary Completion (Actual): May 1, 2026
• Study Completion (Actual): July 1, 2026

Study Registration Dates

• First Submitted: June 24, 2026
• First Submitted That Met QC Criteria: July 15, 2026
• First Posted (Actual): July 21, 2026

Study Record Updates

• Last Update Posted (Actual): July 21, 2026
• Last Update Submitted That Met QC Criteria: July 15, 2026
• Last Verified: September 1, 2025

More Information

Terms related to this study

• Keywords: post appendectomy bowel obstruction
• Additional Relevant MeSH Terms: Intestinal Diseases; Digestive System Diseases; Gastrointestinal Diseases; Intestinal Obstruction
• Other Study ID Numbers: Soh-Med--25-9-9MSSohagUH-DT-20

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No