Transumbilical single-port appendectomy in children: a retrospective study

Area of Science:

• Pediatric Surgery
• Minimally Invasive Surgery
• Surgical Outcomes

Background:

• Acute appendicitis is a common surgical emergency in children.
• Traditional surgical approaches include conventional laparoscopy and open surgery.
• Transumbilical single-incision laparoscopic appendectomy (TSILA) is an emerging minimally invasive technique.

Purpose of the Study:

• To compare the outcomes of TSILA with conventional laparoscopic and open appendectomy in pediatric patients.
• To evaluate the safety and efficacy of TSILA across different grades of appendicitis.

Main Methods:

• Retrospective analysis of 550 pediatric patients (0-18 years) undergoing appendectomy between 2020-2023.
• Patients were stratified by surgical technique (TSILA, conventional laparoscopy, open surgery) and appendicitis grade (I-IV).
• Statistical analysis using Pearson's Chi-squared and ANOVA tests.

Main Results:

• TSILA was performed in 34.5% of cases, demonstrating significantly shorter hospital stays (2.98 days) compared to conventional laparoscopy (4.23 days) and open surgery (5.58 days).
• Postoperative fever rates were lower with TSILA (7.9%) versus conventional laparoscopy (12.7%) and open surgery (27.5%).
• Wound infection rates were similar for TSILA and conventional laparoscopy, both lower than open surgery; TSILA also showed the lowest postoperative antibiotic use.

Conclusions:

• TSILA is a safe and effective surgical option for pediatric appendicitis, particularly in Grades I-III, associated with reduced hospital stays and antibiotic requirements.
• In advanced appendicitis (Grade IV), TSILA provided shorter hospitalization, with comparable complication and antibiotic use rates to conventional methods.