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Pediatric laparoscopic appendectomy for acute appendicitis.

A H Vernon1, K E Georgeson, C M Harmon

  • 1General and GI Surgery Division, Department of Surgery, Brigham and Women's Hospital, Boston, MA 02115, USA. avernon@partners.org [corrected]

Surgical Endoscopy
|November 20, 2003
PubMed
Summary
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Laparoscopic appendectomy for pediatric acute appendicitis shows similar operative times but higher costs compared to open surgery. Further research is needed to identify potential laparoscopic benefits in children.

Area of Science:

  • Pediatric Surgery
  • Surgical Outcomes
  • Health Economics

Background:

  • The clinical benefit of laparoscopic appendectomy for acute appendicitis in children remains debated, especially concerning operative duration and financial implications.
  • Existing literature presents conflicting data on the efficacy and cost-effectiveness of laparoscopic versus open appendectomy in pediatric patients.

Purpose of the Study:

  • To compare the operative time, hospital stay, and total costs of laparoscopic appendectomy versus open appendectomy in a pediatric population.
  • To evaluate the cost-effectiveness of different surgical approaches for acute appendicitis in children.

Main Methods:

  • A retrospective chart review was conducted for 200 children undergoing appendectomy for acute appendicitis.
  • Data were collected over 35 months at a major pediatric teaching hospital, comparing laparoscopic (n=105) and open (n=95) procedures.

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Main Results:

  • Operative times and postoperative hospital lengths of stay were comparable between the laparoscopic and open appendectomy groups.
  • The mean total hospital cost for laparoscopic appendectomy ($5,572) was significantly higher than for open appendectomy ($4,472) (p < 0.01).

Conclusions:

  • Laparoscopic appendectomy for pediatric acute appendicitis demonstrates similar operative times to the open approach but incurs higher overall hospital costs.
  • This study highlights the need for healthcare providers to focus on cost reduction strategies and develop novel outcome measures to better ascertain the benefits of laparoscopy in pediatric surgical care.