Comparison of Single-Dermatome Laparoscopic Appendectomy With Standard Laparoscopic Appendectomy in Terms of Postoperative Pain and Patient Satisfaction: A Randomized Controlled Trial

Background: Laparoscopic appendectomy (LA), used since 1980, is a common surgical technique for acute appendicitis (AA) treatment. Laparoscopic surgical techniques can achieve higher patient satisfaction than conventional open surgery techniques. However, many patients complain of severe pain after laparoscopic abdominal surgeries. In this study, we compared single-dermatome laparoscopic appendectomy (SDLA), wherein all trocars were placed at the same dermatome field, with standard laparoscopic appendectomy (SLA), wherein trocars were placed at multiple dermatome sites, in terms of postoperative pain and patient satisfaction. Materials and Methods: The study was designed as a double-blind randomized controlled trial. Patients who underwent LA for AA between May 2019 and December 2019 were included in the study and randomized into 2 groups, wherein patients were included sequentially. The first group was operated with SLA surgery, whereas the second group was operated with SDLA surgery. All patients were assessed in terms of visual analog scale (VAS) scores, hemodynamic parameters, and patient satisfaction at postoperative 1, 2, 4, 6, 12, and 24 hours. Results: In the SLA technique, VAS values at postoperative 1, 2, and 4 hours were significantly higher than in the SDLA (P=0.009; P<0.05). No significant difference was observed between the surgical techniques in terms of VAS levels at postoperative 6, 12, and 24 hours (P>0.05). In the SDLA group, patient satisfaction was significantly higher than in the SLA group (P=0.024; P<0.05). Conclusions: In our study, SDLA caused less pain in AA cases during postoperative period than SLA. Further, the SDLA method achieved higher patient satisfaction during the postoperative period than the SLA method.