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Feasibility of a laparoscopic approach for generalized peritonitis from perforated appendicitis in children

Hye Kyung Chang1, Seok Joo Han, Seung Hoon Choi

  • 1Department of Pediatric Surgery, Severance Children's Hospital, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea. jtoh@yuhs.ac.

Yonsei Medical Journal
|October 22, 2013
PubMed

Insights

Laparoscopic appendectomy is feasible for children with perforated appendicitis and generalized peritonitis. This approach shows lower wound infection and intestinal obstruction rates compared to open surgery.

Area of Science:

  • Pediatric surgery
  • Minimally invasive surgery
  • Gastrointestinal surgery

Background:

  • Generalized peritonitis secondary to perforated appendicitis is a serious condition in children.
  • Traditional open appendectomy carries risks of complications such as wound infection and intestinal obstruction.

Purpose of the Study:

  • To evaluate the feasibility and outcomes of laparoscopic appendectomy (LA) in pediatric patients with generalized peritonitis due to perforated appendicitis.
  • To compare the results of LA with those of open appendectomy (OA).

Main Methods:

  • Retrospective analysis of medical records of pediatric patients who underwent LA or OA for perforated appendicitis with generalized peritonitis.
  • Comparison of complication rates, including wound infection and intestinal obstruction, between LA and OA groups.

Main Results:

  • Laparoscopic appendectomy was performed in 99 patients, with a conversion rate to open surgery of 10.8%.
  • The incidence of wound infection was significantly lower in the LA group (4.0%) compared to the OA group (12.6%).
  • Long-term follow-up revealed a significantly higher incidence of intestinal obstruction in the OA group (4.6%) versus the LA group (0.0%).

Conclusions:

  • Laparoscopic appendectomy is a feasible surgical option for children with generalized peritonitis from perforated appendicitis.
  • LA offers comparable perioperative complication rates to OA, with the added benefits of reduced wound infections and long-term intestinal obstruction.
Abstract

Keywords:
Appendicitischildrenlaparoscopyperitonitis

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