Comparative Efficacy of Open Versus Laparoscopic Appendicectomy at Lagos University Teaching Hospital: A Retrospective Cohort Analysis

Laparoscopic appendicectomy offers theoretical advantages over open appendicectomy including reduced wound complications, shorter hospital stay, and faster return to activity, but comparative outcome data from Nigerian teaching hospitals where laparoscopic capacity is limited are sparse. This study compares operative time, complications, hospital stay, and return to activity between open and laparoscopic appendicectomy at Lagos University Teaching Hospital, Lagos State. A retrospective cohort design is applied to surgical theatre records and case notes of 320 adult appendicectomy cases (160 open, 160 laparoscopic) performed between 2019 and 2023. Variables include operative time, intraoperative complications, wound infection rate using CDC SSI criteria, length of hospital stay, 30-day readmission, and analgesic requirement. Statistical comparisons use independent t-tests and chi-square tests in SPSS, with propensity score matching applied to reduce selection bias between the two groups. Available comparative surgery literature from South West Nigeria identifies laparoscopic appendicectomy as associated with shorter hospital stay and lower wound infection rates but longer operative time and higher equipment cost compared to open procedures. The Clavien-Dindo classification grades postoperative complications. Findings will contribute evidence for an institutional cost-effectiveness analysis to guide the scale-up of laparoscopic appendicectomy at LUTH. Keywords: laparoscopic appendicectomy, open appendicectomy, comparative outcomes, Lagos, South West Nigeria.