Complicated appendicitis in children: is laparoscopic appendectomy appropriate? A comparative study with the open...

Area of Science:

• Pediatric Surgery
• Minimally Invasive Surgery

Background:

• Laparoscopic appendectomy (LA) is established for uncomplicated appendicitis in children.
• Its use in complicated appendicitis is debated due to concerns about higher infection rates.

Purpose of the Study:

• To retrospectively compare laparoscopic appendectomy (LA) with open appendectomy (OA) for complicated appendicitis in children.
• To evaluate the efficacy and safety of LA in this patient group.

Main Methods:

• Retrospective analysis of 128 children with complicated appendicitis.
• Comparison between 80 patients undergoing LA and 48 patients undergoing OA.
• Data collected included operative time, diet resumption, infectious complications, hospitalization length, and antibiotic duration.

Main Results:

• Laparoscopic appendectomy (LA) showed significantly lower rates of wound infection (1.3% vs 12.5%) and intraabdominal abscess (2.5% vs 14.6%) compared to open appendectomy (OA).
• Patients in the LA group had earlier oral intake and shorter hospital stays.
• Operative time was longer for LA, but no mortality was observed in either group.

Conclusions:

• Laparoscopic appendectomy is a feasible, safe, and effective minimally invasive option for children with complicated appendicitis.
• LA should be considered the initial procedure of choice for most pediatric cases of complicated appendicitis.