Laparoscopic Appendectomy for Early Appendicular Lump in Children: A Single-Institution Experience

The ideal management of appendicular lump in children is still debated, with traditional interval appendectomy being challenged by early laparoscopic intervention. The purpose of this study was to evaluate the safety and efficacy of emergency laparoscopic appendectomy (LA) in children with an early appendicular lump.

A retrospective chart review of 30 patients (≤15 years) presenting with an early appendicular lump who underwent emergency LA over a five-year period was performed. Outcomes measured included conversion rate, operative time, complications, and length of hospital stay.

The mean age was 9.2 ± 2.8 years. The mean duration of symptoms was 3.1 ± 0.9 days. Laparoscopic approach was successful in 28 patients (93.3%). Two (6.7%) patients had to be converted to open surgery due to dense adhesions and inability to delineate anatomy clearly. The mean operative time was 68 ± 18 minutes. Operative findings included phlegmon in 18 patients (60%), contained perforation in 10 patients (33%), and abscess (≤5 cm) in two patients (6.6 %). Minor complications were seen three patients (10%). One port-site infection and two postoperative ileus occurred; all were managed conservatively. No major complications or re-operations were recorded. The mean postoperative hospital stay was 3.2 ± 1.1 days.

We conclude that emergency LA for early appendicular lump in carefully selected, hemodynamically stable children is a safe and feasible procedure. It offers the benefits of minimally invasive surgery while avoiding the morbidity and psychological burden of a delayed operation.