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Single-port appendectomy in obese children: an optimal alternative?
Thomas Petnehazy1, A K Saxena, H Ainoedhofer
1Department of Pediatric and Adolescent Surgery, Medical University of Graz, Graz, Austria. Thomas.Petnehazy@klinikum-graz.at
Insights
Single-port appendectomy (SPA) is a safe and effective minimal access approach for obese children with appendicitis. This technique offers cosmetic benefits and a low complication rate, making it a viable alternative for this patient group.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Gastrointestinal Surgery
Background:
- Single-port appendectomy (SPA) is an alternative surgical approach.
- Obesity in children presents unique surgical challenges.
- Evaluating SPA's efficacy in obese pediatric patients is crucial.
Purpose of the Study:
- To assess the outcomes of SPA in obese children.
- To compare SPA results in obese versus normal-weight pediatric patients.
- To identify potential benefits and complications of SPA in this cohort.
Main Methods:
- Retrospective review of 94 pediatric appendectomies (2003-2009).
- Categorization of patients into normal weight (65) and obese (29) groups.
- Analysis of operative time, complications, oral intake, and histopathology.
Main Results:
- No significant difference in operative time between obese and normal-weight groups.
- Obese group: one wound healing disturbance. Normal weight group: one bleeding, one infection.
- No difference in oral intake initiation; diverse histopathological findings noted.
Conclusions:
- SPA is a safe and effective alternative for appendectomy in obese children.
- SPA offers advantages in peritoneal cavity evaluation and cosmetic outcomes.
- Minimal intra-operative incidents support SPA as a valid minimal access approach.
Introduction:
The aim of this study was to evaluate our experience with single-port appendectomy (SPA) in obese children.
Methods:
From January 2003 to June 2009, 94 SPA (65 women and 29 men, mean age of 12.4 years) were performed in children with appendicitis. Sixty-five of these patients were found to have normal weight, whereas 29 were obese. Patients' records were evaluated regarding operative time, intra- and post-operative complications, initiation of oral intake and histopathological findings.
Results:
There was no significant difference in operative time between obese and normal weight patients. In the obese group, one wound healing disturbance was documented. In the normal weight group, there were one post-operative bleeding and one wound infection. There was no difference with regards to the introduction of feeds following appendectomy between the groups. Histological examinations revealed 15 normal, 32 acute, 21 phlegmonous, 20 chronic and two perforated cases of appendicitis, three neurogenic appendicopathies and one case of enterobius vermicularis related appendicitis.
Conclusions:
Our results indicate that the advantages of single-port appendectomy in the evaluation of the peritoneal cavity, the minimal rate of intra-operative incidents with this technique and superior cosmetics validate this alternative approach of minimal access appendectomy in obese children.
