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Laparoscopic versus conventional appendectomy in children
1Pediatric Surgery Unit, Ain Shams University, Cairo, Egypt.
Insights
Laparoscopic appendectomy (LA) offers advantages over conventional appendectomy (CA) in children, including shorter hospital stays and faster recovery. This minimally invasive approach also resulted in fewer wound complications and better cosmetic outcomes.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
Background:
- Appendicitis is a common surgical emergency in children.
- Conventional appendectomy (CA) has been the standard treatment.
- Recurrent subacute appendicitis also requires surgical intervention.
Purpose of the Study:
- To compare the outcomes of laparoscopic appendectomy (LA) versus conventional appendectomy (CA) in pediatric patients.
- To evaluate differences in hospitalization time, recovery, and complications between the two surgical methods.
Main Methods:
- A comparative study over 6 months involving 48 children undergoing CA and 34 children undergoing LA.
- Patients ranged from 4 to 12 years old with acute or recurrent subacute appendicitis.
- Key outcomes measured included operative time, hospitalization duration, return to normal activity, wound complications, and cosmetic results.
Main Results:
- Laparoscopic appendectomy (LA) had a longer operative time (76 min) compared to conventional appendectomy (CA) (50 min).
- 95% of LA patients had less than 2 days' hospitalization versus 45% for CA.
- LA patients returned to normal activity in an average of 7 days, compared to 12 days for CA (P < 0.001).
- LA resulted in fewer wound complications and superior cosmetic outcomes.
Conclusions:
- Laparoscopic appendectomy (LA) is a safe and effective alternative for pediatric appendicitis.
- LA offers significant advantages including shorter hospitalization, earlier ambulation, and improved cosmetic results compared to CA.
- The exploratory nature of LA may also be beneficial in certain cases.
Abstract:
Over a period of 6 months, 48 children who underwent conventional appendectomy (CA) were compared to 34 children who had laparoscopic appendectomy (LA) for acute and recurrent subacute appendicitis. Their ages ranged from 4 to 12 years (mean 8). LA took significantly longer, 76 min, versus 50 min for CA. Less than 2 days' hospitalization was required in 95% of LA cases and 45% of CA cases. Time to return to normal activity averaged 7 days for LA and 12 days for CA (P < 0.001). Wound complications were fewer and the cosmetic appearance was most satisfactory in LA patients. LA is a safe operation that has the advantage of being exploratory, with shorter hospitalization time, early ambulation, and superior cosmetic results.