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Laparoscopy for suspected appendicitis in children: May a macroscopically normal appendix be left in situ?
J Dingemann1, M Metzelder, J F Kuebler
1Department of Pediatric Surgery, Hannover Medical School, Germany. dingemann.jens@mh-hannover.de
Summary
Leaving a normal-appearing appendix in place during laparoscopic surgery for suspected appendicitis is safe. Most children experienced no or few symptoms, with no re-operations needed.
Area of Science:
- Pediatric Surgery
- Gastrointestinal Surgery
Background:
- 10-20% of laparoscopic appendectomies reveal a macroscopically normal appendix.
- Surgical strategy for normal appendices during appendicitis surgery is debated.
Purpose of the Study:
- To analyze outcomes of leaving inconspicuous appendices in situ after laparoscopic exploration for suspected appendicitis in children.
Main Methods:
- 188 children with suspected appendicitis underwent laparoscopy (2002-2006).
- Normal appendices were left in situ; inflamed appendices were removed.
- Follow-up assessed complications, re-operations, admissions, and consultations.
Main Results:
- 21 children (11%) had normal appendices left in situ.
- No immediate postoperative complications occurred; mean hospital stay was 2.7 days.
- During mean 25-month follow-up, 95% were symptom-free; no re-admissions or appendicitis operations.
Conclusions:
- A macroscopically inconspicuous appendix can be safely left in situ during laparoscopy for suspected appendicitis.
- Larger studies are needed to confirm these findings in pediatric populations.
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