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Ten-year experience with pediatric laparoscopic appendectomy--are we getting better?
Stephanie Phillips1, J Mark Walton, Ian Chin
1Division of Pediatric Surgery, McMaster Children's Hospital, Hamilton, Ontario, Canada L8N 3Z5.
Journal of Pediatric Surgery
|June 7, 2005
Summary
Ten years of laparoscopic appendectomy (LA) experience led to significant reductions in operating and anesthetic times for acute and perforated appendicitis. Postoperative abscess rates and conversion rates also decreased, particularly in perforated cases.
Area of Science:
- Minimally Invasive Surgery
- Surgical Outcomes Research
- Gastrointestinal Surgery
Background:
- Laparoscopic appendectomy (LA) has become a standard procedure for appendicitis.
- Evaluating surgical experience over time is crucial for process improvement.
Purpose of the Study:
- To compare early (1994-1997) and recent (2001-2003) outcomes of laparoscopic appendectomy (LA).
- To assess the impact of accumulated experience on surgical efficiency and patient outcomes.
Main Methods:
- Retrospective chart review of appendicitis cases from two distinct periods (1994-1997 and 2001-2003).
- Analysis of operating time, anesthetic time, and postoperative outcomes, including conversions to open surgery.
- Comparison of data between the two study periods.
Main Results:
- Significant decreases in operating times for both acute appendicitis (AA) and perforated appendicitis (PA).
- Significant reductions in anesthetic times for AA and PA.
- Marked decrease in conversion rates for PA (23.4% to 3.5%) and a significant drop in postoperative abscess incidence in PA (36.2% to 16.5%).
Conclusions:
- Accumulated experience over a decade in LA has led to improved surgical efficiency.
- LA demonstrates improved safety and outcomes, especially in managing complicated cases like perforated appendicitis.
- Continued experience refines LA, reducing operative times and complication rates.