Pediatric appendectomy in developing countries: How does it differ from international experience?

Area of Science:

• Pediatric Surgery
• Minimally Invasive Surgery
• Surgical Outcomes

Background:

• Existing literature suggests laparoscopic appendectomy (LA) is marginally superior to open appendectomy (OA) in pediatric patients.
• Data from developing countries regarding this comparison is limited.
• This study details a 7-year experience from a Lebanese university hospital.

Purpose of the Study:

• To compare the outcomes of laparoscopic appendectomy (LA) versus open appendectomy (OA) in pediatric patients.
• To assess the efficacy and safety of both surgical approaches in a developing country context.
• To compare local results with international findings.

Main Methods:

• A retrospective, single-center study included pediatric patients (<15 years) undergoing appendectomy.
• Operative techniques, patient characteristics, intraoperative findings, operative timing, length of stay, and short-term postoperative complications were analyzed.
• Statistical analysis employed Chi-square, Fisher's exact test, Student's t-test, and ANOVA.

Main Results:

• A total of 84 pediatric appendectomies were performed: 52 OA and 32 LA.
• Laparoscopic appendectomy demonstrated a reduced rate of surgical site infection (SSI) compared to open appendectomy.
• No significant differences were observed between LA and OA in other studied parameters.

Conclusions:

• In line with global trends, laparoscopic appendectomy (LA) offers a significant advantage in reducing SSI in pediatric appendectomies.
• Both LA and OA demonstrated comparable outcomes in other aspects, including operative timing and length of stay.
• This study contributes valuable data from a developing country on the comparative effectiveness of pediatric appendectomy techniques.