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Laparoscopic Appendectomy in Children With Perforated Appendicitis: A Meta-Analysis

Shun Zhang1, Tao Du, Xiaohua Jiang

  • 1Gastrointestinal Surgery, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, P.R. China.

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
|May 5, 2017
PubMed

Insights

Laparoscopic appendectomy (LA) in children with perforated appendicitis shows fewer wound infections and bowel obstructions compared to open appendectomy (OA). However, LA was linked to a higher rate of intra-abdominal abscesses.

Area of Science:

  • Pediatric Surgery
  • Gastrointestinal Surgery
  • Evidence-Based Medicine

Background:

  • Perforated appendicitis is a common surgical emergency in children.
  • Surgical management strategies vary, impacting patient outcomes.
  • Comparing laparoscopic appendectomy (LA) and open appendectomy (OA) is crucial for optimizing pediatric care.

Purpose of the Study:

  • To conduct a meta-analysis comparing surgical procedures for perforated appendicitis in pediatric patients.
  • To evaluate the influence of laparoscopic appendectomy versus open appendectomy on postoperative outcomes.

Main Methods:

  • Systematic literature search across multiple databases (PubMed, Embase, Ovid, Cochrane, Web of Science).
  • Independent quality assessment and data extraction by two reviewers.
  • Meta-analysis using fixed-effect models to calculate relative risk (RR) for postoperative variables.

Main Results:

  • Nine studies were included in the meta-analysis.
  • Laparoscopic appendectomy (LA) showed a statistically significant lower risk for wound infection (RR=0.88) and bowel obstruction (RR=0.79).
  • LA was associated with a statistically significant higher risk for intra-abdominal abscess (RR=1.38) compared to open appendectomy (OA).

Conclusions:

  • Laparoscopic appendectomy (LA) is associated with reduced rates of wound infections and bowel obstruction in pediatric perforated appendicitis.
  • Open appendectomy (OA) may be associated with a lower incidence of intra-abdominal abscesses.
  • The choice between LA and OA requires careful consideration of potential risks and benefits in pediatric patients.
Abstract

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