Is peritoneal drainage necessary in childhood perforated appendicitis?--a comparative study

Area of Science:

• Pediatric Surgery
• Surgical Complications
• Appendicitis Management

Background:

• Perforated appendicitis in children can lead to significant postoperative infective complications.
• The role of peritoneal drainage (PD) in managing these complications is debated.

Purpose of the Study:

• To evaluate the impact of peritoneal drainage (PD) on postoperative infective complications in children with perforated appendicitis.

Main Methods:

• Retrospective and prospective evaluation of 226 children with perforated appendicitis.
• Comparison of complication rates (wound infection, intraabdominal abscess, small bowel obstruction) between groups with and without PD.
• Analysis of postoperative recovery parameters including hospitalization, antibiotic use, and feeding times.

Main Results:

• The group with peritoneal drainage (PD) showed higher rates of wound infection (28.4% vs. 16.2%) and intraabdominal abscess (12.8% vs. 3.4%) compared to the no drainage (ND) group.
• Patients with PD experienced significantly longer hospital stays, antibiotic use, NG tube usage, and delayed oral feeding and temperature normalization.
• No significant difference in small bowel obstruction rates was observed between the groups.

Conclusions:

• Peritoneal drainage is associated with increased postoperative infective complications and prolonged recovery in pediatric perforated appendicitis.
• The study recommends discontinuing the use of peritoneal drainage in childhood appendicitis cases.