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Laparoscopic appendectomy in children
G Stringel1, J L Zitsman, I Shehadi
1Department of Surgery, Westchester County Medical Center, Valhalla, NY, USA.
JSLS : Journal of the Society of Laparoendoscopic Surgeons
|January 1, 1997
Summary
Laparoscopic appendectomy in children is safe and effective, with complication rates similar to open surgery. While operative time is longer, further training may establish it as the preferred method for appendicitis.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
Background:
- The superiority of laparoscopic appendectomy over open appendectomy remains unclear.
- Early evaluation of laparoscopic appendectomy in pediatric patients is necessary.
Purpose of the Study:
- To assess the safety, effectiveness, technical challenges, and economic aspects of laparoscopic appendectomy in children.
- To compare early outcomes of laparoscopic appendectomy with traditional open appendectomy.
Main Methods:
- Retrospective review of 50 pediatric laparoscopic appendectomy cases (September 1994 - September 1996).
- Patient age range: 6-18 years.
- Included diagnoses: acute nonperforated appendicitis, perforated appendicitis, appendiceal fibrosis, and normal appendix.
Main Results:
- Conversion to open appendectomy occurred in 5 patients due to technical difficulties.
- Postoperative complications included incomplete appendectomy (requiring completion surgery), pelvic abscess, bowel obstruction, and wound infection.
- Overall complication rate was comparable to open appendectomy.
Conclusions:
- Laparoscopic appendectomy is a safe and effective pediatric procedure.
- Operative time is longer than open appendectomy, but hospitalization and complication rates are similar.
- Economic benefits require further assessment; improved training and techniques may establish it as the standard of care for appendicitis.