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Postoperative bowel obstruction after laparoscopic and open appendectomy in children: a 15-year experience

Christos Kaselas1, Francesco Molinaro, Isabelle Lacreuse

  • 1Department of Pediatric Surgery, Hôpitaux Universitaires de Strasbourg, Hôpital de Hautepierre, 67098 Strasbourg Cedex, France. xkaselas@otenet.gr

Journal of Pediatric Surgery
|July 29, 2009
PubMed

Insights

Laparoscopic appendectomy significantly reduces the risk of postoperative bowel obstruction (PBO) in children compared to open surgery. The surgical approach, not disease severity, influences PBO incidence.

Area of Science:

  • Pediatric Surgery
  • Gastrointestinal Surgery

Background:

  • Postoperative bowel obstruction (PBO) is a potential complication following appendectomy.
  • Understanding risk factors associated with PBO is crucial for optimizing surgical outcomes in children.

Purpose of the Study:

  • To determine and evaluate the incidence of postoperative bowel obstruction (PBO) after both laparoscopic and open appendectomy in pediatric patients.
  • To compare the rates of PBO between the two surgical approaches.

Main Methods:

  • A retrospective review of medical records for children undergoing appendectomy between 1992 and 2007.
  • Data collected included patient demographics, surgical approach (laparoscopic vs. open), PBO development, and treatment.
  • Statistical comparison using chi-squared analysis to evaluate PBO incidence between groups.

Main Results:

  • The overall incidence of PBO was 2.2% across 1684 pediatric appendectomies.
  • Laparoscopic appendectomy demonstrated a significantly lower PBO incidence of 1.19% compared to 4.51% in the open appendectomy group (P < .0001).
  • This difference was observed irrespective of appendicitis severity (perforated vs. non-perforated).

Conclusions:

  • Laparoscopic appendectomy is associated with a reduced risk of developing postoperative bowel obstruction in children.
  • The choice of surgical approach is a significant determinant of PBO incidence, more so than the severity of appendicitis.
Abstract

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