Clinical observation of laparoscopic surgery for pediatric periappendiceal abscess

This study aimed to investigate the changes in inflammatory markers such as CRP, PCT, and IL-6 in the treatment of pediatric periappendiceal abscess and to explore more effective treatment strategies by observing the changes in inflammatory and general indicators after laparoscopic surgery and conservative treatment. The findings are expected to provide more precise guidance for clinicians in making diagnostic and treatment decisions.

This study conducted a single-center retrospective analysis of 80 eligible pediatric patients with periappendiceal abscess treated in our hospital's Pediatric Surgery Department from January 1, 2019, to December 31, 2024. All patients were definitively diagnosed with periappendiceal abscess based on symptoms/signs, serological examinations, and imaging studies (right lower abdominal color Doppler ultrasound, lower abdominal CT), meeting the inclusion criteria. All patients presented with fever ± nausea/vomiting, right lower abdominal pain, rebound tenderness (+), McBurney's point tenderness (+), positive colonic inflation test, and ultrasound-confirmed inflammatory mass in the right lower quadrant. Patients were allocated to surgical treatment group or conservative treatment group according to intervention methods. Clinical efficacy, inflammatory indicators, and general condition changes were compared between groups.

In terms of clinical efficacy, there was a statistically significant difference between children undergoing laparoscopic surgery and those receiving conservative treatment (P < 0.05); in terms of inflammatory indicators, both the surgical treatment group and the conservative treatment group showed rapidly declining trends in inflammatory markers including WBC, IL-6, CRP, and PCT (P < 0.05), with no significant difference in the rate of decline between the surgical and conservative groups (P > 0.05); in terms of general conditions, there was no statistically significant difference in hospitalization days between the two groups (P > 0.05), while the time to first flatus and duration of abdominal pain were significantly better in the surgical treatment group compared to the conservative treatment group (P < 0.05).

This study demonstrates that laparoscopic appendectomy in children with periappendiceal abscess yields superior outcomes in general recovery compared to conservative treatment (P < 0.05), while both groups exhibit equivalent efficacy in inflammatory marker resolution, with rapid declining trends observed post-intervention. These findings confirm that conservative management requires prolonged duration and achieves suboptimal therapeutic efficacy for pediatric periappendiceal abscess; whereas laparoscopic surgery more effectively enhances patients' immune function, accelerates inflammation resolution, improves treatment outcomes, and significantly shortens clinical management duration, thereby providing precise guidance for clinical decision-making. However, as a single-center retrospective study with limited sample size, further validation through large-scale prospective studies is warranted.