Comparative Analysis of Open Versus Laparoscopic Appendicectomy Outcomes in a Nigerian Tertiary Hospital Setting

Laparoscopic appendicectomy has supplanted open surgery as the preferred approach in high-income settings, yet comparative outcome data specific to Nigerian tertiary hospitals remain sparse. This study provides a rigorous comparative analysis of open versus laparoscopic appendicectomy outcomes at a teaching hospital in Lagos State, South West Nigeria, from 2019 to 2023. A retrospective matched cohort design compared 120 patients undergoing open appendicectomy with 120 matched patients who underwent laparoscopic appendicectomy, controlling for age, sex, perforation status, and ASA classification. Primary outcomes were operative time, 30-day SSI rate, hospital stay, return to work, and total treatment cost. Laparoscopic appendicectomy resulted in significantly lower SSI rates (4.2% versus 12.5%), shorter hospital stays (mean 1.6 versus 3.4 days), and earlier return to work (mean 7 versus 14 days). Operative time was longer for laparoscopic cases (mean 52 versus 38 minutes). Treatment cost was 18% higher for laparoscopic procedures. The cost differential diminished when indirect costs including prolonged recovery were incorporated. The study supports expanded adoption of laparoscopic appendicectomy at Nigerian teaching hospitals and recommends investment in laparoscopic infrastructure, standardized training curricula, and health technology assessment frameworks to guide national surgical policy in South West Nigeria. Keywords: appendicectomy, laparoscopy, appendicitis, surgical outcomes, cost analysis