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Intraabdominal abscess following open and laparoscopic appendectomy in the pediatric population
R McKinlay1, S Neeleman, R Klein
1Department of Surgery, University of Arizona Affiliated Hospitals, 1501 North Campbell Avenue, Tucson, AZ 85724, USA.
Insights
Laparoscopic appendectomy (LA) and open appendectomy (OA) show similar intra-abdominal abscess (IAA) rates in children. LA is safe for perforated appendicitis, not increasing IAA risk compared to OA.
Area of Science:
- Pediatric Surgery
- Surgical Outcomes
- Infectious Disease
Background:
- Conflicting data exists regarding intra-abdominal abscess (IAA) rates after laparoscopic appendectomy (LA) versus open appendectomy (OA).
- Appendectomy is a common pediatric surgical procedure.
- Understanding infection risks associated with different surgical approaches is crucial for patient care.
Purpose of the Study:
- To compare the incidence of intra-abdominal abscess (IAA) following laparoscopic appendectomy (LA) and open appendectomy (OA) in children.
- To evaluate the safety of LA for perforated appendicitis regarding IAA risk.
Main Methods:
- Retrospective chart review of 324 children who underwent appendectomy.
- Analysis of IAA incidence based on surgical approach (LA vs. OA).
- Specific analysis of IAA rates in cases of perforated appendicitis.
Main Results:
- A total of 324 appendectomies were performed: 204 (63.0%) laparoscopically and 119 (36.7%) open.
- The overall IAA rate was 4.6% (15/324), with 3.4% in the LA group and 6.7% in the OA group (p=NS).
- For perforated appendicitis, IAA rates were 15% for LA and 10% for OA (p=NS).
Conclusions:
- There is no statistically significant difference in IAA rates between LA and OA in children.
- Laparoscopic appendectomy can be safely used for perforated appendicitis without an increased risk of IAA.
- LA is a viable and safe option for pediatric appendectomy, including complicated cases.
Background:
Studies comparing intraabdominal abscess (IAA) rates following laparoscopic appendectomy (LA) and open appendectomy (OA) have shown conflicting results.
Methods:
The charts of 324 children undergoing appendectomy were reviewed retrospectively to examine the incidence of IAA.
Results:
Of the 324 appendectomies, 204 (63.0%) were completed laparoscopically and 119 (36.7%) were performed open. The conversion rate was 0.2% (1/324). Of the 15 (4.6%) IAAs, 7 occurred in the LA group (3.4%) and 8 occurred in the OA group (6.7%) [p = not significant (NS)]. The incidence of IAA for perforated appendicitis for LA was 15% (7/46) and that for OA was 10% (7/70) (p = NS).
Conclusion:
This study demonstrates no statistically significant difference in the rate of IAA among children following LA and OA. LA can be performed for perforated appendicitis without increasing the risk of IAA.