Bowel Obstruction Post Open Versus Laparoscopic Appendectomy

July 15, 2026 updated by: Nazeh Philip alabd, Sohag University

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

Intervention / Treatment

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

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Egypt
      • Sohag, Egypt
        • Sohag University Hospitals

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

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

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

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

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
Time Frame: 6 months
6 months

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
• Operative time
Time Frame: : During operation (from incision to closure)
: During operation (from incision to closure)
Analgesic requirement
Time Frame: From postoperative Day 0 through postoperative Day 7.
From postoperative Day 0 through postoperative Day 7.
Postoperative pain
Time Frame: Postoperative Day 1.
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
Time Frame: From the day of surgery until hospital discharge (average of 2-5 days).
From the day of surgery until hospital discharge (average of 2-5 days).

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sohag University

Investigators

  • Study Director: osama abdlrahem oraby, professor, Sohag University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

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

Additional Relevant MeSH Terms

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

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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