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Laparoscopy utilization and outcomes for appendicitis in small children

Nathan P Zwintscher1, Eric K Johnson, Matthew J Martin

  • 1Department of Surgery, Madigan Army Medical Center, Tacoma, WA 98431, USA.

Journal of Pediatric Surgery
|October 1, 2013
PubMed

Insights

Laparoscopic appendectomy (LA) is increasingly used in young children and offers lower complication rates and shorter hospital stays compared to open surgery. This trend shows LA is a safe and effective option for appendicitis in children 5 years and younger.

Area of Science:

  • Pediatric Surgery
  • Minimally Invasive Surgery
  • Gastrointestinal Surgery

Background:

  • Open appendectomy has been the traditional approach for appendicitis in young children.
  • Laparoscopic appendectomy (LA) utilization has been historically lower in this age group.
  • Data on LA trends and outcomes in children 5 years or younger is limited.

Purpose of the Study:

  • To analyze the utilization trends of laparoscopic appendectomy (LA) in children aged 5 years or younger.
  • To evaluate the outcomes, including complications and length of stay, associated with LA in this pediatric population.
  • To compare LA outcomes with open appendectomy in young children with acute appendicitis.

Main Methods:

  • Retrospective analysis of the Kids' Inpatient Database (KID) for 2000, 2003, and 2006.
  • Inclusion of 16,028 inpatient admissions for children 5 years or younger undergoing appendectomy for acute appendicitis.
  • Review of laparoscopy frequency, hospital length of stay, and complication rates.

Main Results:

  • Laparoscopic appendectomy utilization increased significantly from 11.4% in 2000 to 31.3% in 2006.
  • LA was more frequently performed in children's hospitals (P<0.001).
  • LA was associated with fewer overall complications (OR: 0.80) and shorter hospital stays (0.54 days reduction), including in perforated cases.

Conclusions:

  • Laparoscopic appendectomy is gaining acceptance and shows increasing utilization for treating appendicitis in children 5 years and younger.
  • LA demonstrates a comparatively low complication rate and reduced hospital length of stay in this age group.
  • Laparoscopic appendectomy is a safe and effective treatment option, even for complicated perforated appendicitis in young children.
Abstract

Keywords:
AppendicitisLaparoscopic appendectomyLaparoscopy

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