Is laparoscopic appendectomy in children associated with an uncommon postoperative complication?

Area of Science:

• Pediatric Surgery
• Gastrointestinal Surgery
• Surgical Complications

Background:

• Laparoscopic appendectomy (LA) is debated due to high intra-abdominal abscess (IAA) rates.
• Post-laparoscopic appendectomy complications (PLAC) can occur after discharge in pediatric patients.

Purpose of the Study:

• To report and characterize post-laparoscopic appendectomy complications (PLAC) in pediatric patients.
• To investigate the incidence and clinical presentation of PLAC following laparoscopic appendectomy.

Main Methods:

• A 5-year retrospective review of pediatric patients undergoing laparoscopic appendectomy (LA) or open appendectomy (OA).
• Diagnosis of PLAC based on specific criteria: timing, clinical/laboratory findings, and ultrasonography.
• Exclusion of patients with intraoperative complications or severe appendicitis.

Main Results:

• Among 112 LA patients, 15 (13.4%) developed PLAC after discharge.
• PLAC occurred at 2.7 days post-LA, with no significant difference between normal or pathological appendices.
• Ultrasound findings included fluid, mesenteric fat edema, and bowel wall thickening; one patient developed IAA.

Conclusions:

• PLAC may stem from localized infection due to CO2 pneumoperitoneum and thermal effects during LA.
• Delayed appearance of PLAC is consistent with interstitial infection.
• Antibiotic treatment demonstrated efficacy in managing PLAC.