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[APPENDECTOMY FOR COMPLICATED APPENDICITIS IN CHILDREN--LAPAROSCOPIC OR OPEN?]
Harefuah
|February 23, 2016
Summary
Laparoscopic appendectomy is safe and effective for complicated appendicitis in children, offering benefits over open surgery. This study found no significant difference in complication rates between the two methods.
Area of Science:
- Pediatric surgery
- Gastrointestinal surgery
Background:
- Laparoscopic appendectomy (LA) is standard for simple appendicitis.
- Its use in complicated appendicitis (gangrenous or perforated) remains debated.
Purpose of the Study:
- To compare outcomes of LA versus open appendectomy (OA) in children with uncomplicated and complicated appendicitis.
Main Methods:
- Retrospective analysis of pediatric patients (<18 years) undergoing LA or OA from 2008-2011.
- Patients categorized by appendicitis severity (uncomplicated vs. complicated) and surgical approach (LA vs. OA).
- Comparison of demographic, pre-operative, intra-operative, and post-operative data.
Main Results:
- 335 children underwent appendectomy; 26.9% had perforated appendicitis.
- No significant differences in operative times or complication rates between LA and OA for either appendicitis type.
- Shorter length of stay (LOS) observed in uncomplicated cases treated with LA.
- Low conversion rate (1.36%) from LA to OA; one cecal injury in OA group; no mortalities.
Conclusions:
- Laparoscopic appendectomy is a feasible and safe option for complicated appendicitis in children.
- LA offers advantages in visualization and cosmesis compared to OA.
- No increased risks associated with LA for complicated appendicitis.
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