Laparoscopic versus open appendectomy in children: a randomized controlled trial from a developing country.

Area of Science:

• Pediatric Surgery
• Minimally Invasive Surgery
• Surgical Outcomes

Background:

• Acute appendicitis is a frequent surgical emergency in children.
• Surgical management options include laparoscopic appendectomy (LA) and open appendectomy (OA).
• Comparative outcome data is crucial for clinical decision-making.

Purpose of the Study:

• To compare the outcomes of laparoscopic versus open appendectomy in pediatric acute appendicitis.
• Key outcome measures include surgical duration, hospital stay, and wound infection rates.
• To evaluate the technical demands of each surgical approach.

Main Methods:

• A prospective randomized controlled trial was conducted.
• 126 pediatric patients with acute appendicitis were randomized to LA or OA groups.
• Surgical duration, length of hospital stay (LOS), and wound infection rates were recorded.

Main Results:

• No significant difference in wound infection rates was observed between LA and OA groups (p=0.31).
• Laparoscopic appendectomy was associated with a shorter mean hospital stay (34±13h vs. 40±11h, p=0.01).
• Open appendectomy had a significantly shorter mean operative time (39±8min vs. 56±24min, p<0.0001).

Conclusions:

• Laparoscopic and open appendectomy demonstrate comparable outcomes regarding length of hospital stay and wound infection rates in children.
• Laparoscopic appendectomy presents greater technical challenges compared to the open approach.
• The choice of surgical technique should consider both patient outcomes and surgical complexity.