March 2026, Volume 4, Issue 3

Author

B. Sridhar, Sadhana M and Vimalnathan M

Abstract

Background: Open appendicectomy is still commonly performed, particularly in hospitals with limited resources. Traditionally, the peritoneum is closed to restore normal anatomy and to reduce adhesions. However, recent experimental and clinical studies suggest that leaving the peritoneum open may shorten surgery time and reduce postoperative discomfort without increasing complications. Objectives: To compare peritoneal closure and non-closure during open appendicectomy in terms of operative time, postoperative pain, need for analgesics, length of hospital stay, and postoperative complications. Methods: This randomized controlled study was carried out at a tertiary care teaching hospital in South India between October 2017 and October 2018. A total of 200 patients with uncomplicated acute appendicitis undergoing open appendicectomy were randomly divided into two groups: peritoneal closure (Group A, n=100) and peritoneal non-closure (Group B, n=100). Outcomes assessed were operative duration, postoperative pain measured using the Visual Analogue Scale (VAS), analgesic requirement, postoperative complications, and length of hospital stay. Data were analyzed using SPSS software, and a p-value <0.05 was considered statistically significant. Results: The mean operative time was significantly shorter in the non-closure group (87.5 minutes) compared to the closure group (100 minutes) (p<0.001). A higher requirement for postoperative analgesics was seen more often in the closure group (41%) than in the non-closure group (25%) (p=0.016). Postoperative pain scores, complication rates, and duration of hospital stay were similar in both groups. Conclusion: Leaving the peritoneum open during open appendicectomy reduces operative time and the need for postoperative analgesics without increasing complications. This supports the routine use of peritoneal non-closure in patients with uncomplicated appendicitis.