[Open versus laparoscopic appendectomy in children in a regional hospital in Israel]

Although laparoscopic appendectomy (LA) has already been found to be associated with greater diagnostic accuracy, less post-operative pain and shorter hospital stay as compared to open appendectomy (OA), questions remain regarding the advantages of this approach and it is still not widely practiced in children, especially in regional hospitals.

This study aims to evaluate Ha'emek Medical Center's initial experience with pediatric OA and LA between July 2002 and October 2003.

This study is a retrospective outcome analysis of pediatric OA and LA. Records of all children aged 0 to 14 years who underwent appendectomy for acute appendicitis, were reviewed. Operating time (OT), antibiotic treatment, analgesic needs, length of stay (LOS) and complications were analyzed and were compared between the groups.

Seventy-one children with acute appendicitis underwent appendectomy in Ha'emek Medical Center between July 2002 and October 2003. Fifty-two children underwent OA and 19 underwent LA. There were no differences in age, sex, race, or stage of the appendicitis between the groups. LA took longer than OA (68 vs 37 minutes), length of stay was shorter for LA (2.8 vs 4.3 days), complications rate was not significantly different and overall hospital expenses were less for LA (NIS 5,756.95 vs. NIS 6,055.47).

LA is as safe as OA and although it takes longer, recovery is faster. We, therefore, conclude that LA can be safely recommended for treating children with acute non-perforated appendicitis.