IMPACT OF THE APPENDICEAL POSITION ON THE DIAGNOSIS AND TREATMENT OF PEDIATRIC APPENDICITIS

Area of Science:

• Pediatric Surgery
• Gastrointestinal Surgery

Background:

• Appendicitis is common in children.
• Appendix location can vary, potentially affecting symptoms and surgical outcomes.

Purpose of the Study:

• To analyze symptom variations based on appendiceal position in pediatric patients.
• To confirm the safety and efficacy of laparoscopic appendectomy across all appendix locations.

Main Methods:

• Retrospective analysis of 1,736 pediatric laparoscopic appendectomies.
• Classification of patients into four appendiceal location groups: anterior, pelvic, retrocecal, and subhepatic.
• Statistical analysis using Kruskal-Wallis and chi-square tests with Bonferroni correction (p<0.05).

Main Results:

• Abdominal pain was the only symptom showing statistically significant differences between groups.
• Higher perforation rates were observed in subhepatic and pelvic appendicitis.
• Postoperative complications were similar, except for increased bowel obstruction in pelvic appendicitis.
• No significant differences in intraoperative complications or conversions; technical difficulty and operative time were higher in subhepatic cases.

Conclusions:

• Clinical symptoms of appendicitis show minimal variation with appendix position.
• Laparoscopic appendectomy is a safe and effective surgical approach for pediatric appendicitis, irrespective of the appendix's anatomical location.