Improved outcomes for laparoscopic appendectomy compared with open appendectomy in the pediatric population

Area of Science:

• Pediatric Surgery
• Minimally Invasive Surgery
• Surgical Outcomes

Background:

• Appendectomy is a frequent emergency surgery for children.
• This study evaluated outcomes during a transition from open to laparoscopic appendectomy.
• Institutional experience with pediatric appendectomy was examined.

Purpose of the Study:

• To assess the safety and efficacy of laparoscopic appendectomy in pediatric patients.
• To compare outcomes between open and laparoscopic appendectomy in children.
• To analyze the learning curve for laparoscopic appendectomy in a pediatric tertiary care setting.

Main Methods:

• Retrospective review of 223 pediatric appendectomies (age ≤ 20 years) over two years.
• Data included demographics, comorbidities, operative details, outcomes, and complications.
• Comparison between open (n=179) and laparoscopic (n=44) appendectomy groups.

Main Results:

• Laparoscopic appendectomy showed longer initial operative times but decreased with experience.
• Laparoscopic cases had significantly lower estimated blood loss, shorter IV pain medication duration, and reduced hospital stay.
• While not statistically significant, the laparoscopic group had lower rates of wound infections, intra-abdominal abscesses, and postoperative ileus.

Conclusions:

• Laparoscopic appendectomy is a safe and effective alternative for pediatric appendicitis.
• The procedure is associated with benefits including shorter hospital stays and less postoperative pain.
• Surgical proficiency in laparoscopic appendectomy improves outcomes over time.