[Pro and contra laparoscopic appendectomy in childhood]

Area of Science:

• Pediatric Surgery
• Minimally Invasive Surgery
• Surgical Indications

Background:

• The evolution of indications for appendectomy in pediatric surgery.
• Comparison of patient groups before and after clinic consolidation.
• Differing criteria for laparoscopic appendectomy between two surgical sites.

Purpose of the Study:

• To clarify changes in appendectomy indications since the advent of minimally invasive surgery in children.
• To compare outcomes based on varying laparoscopic appendectomy criteria.
• To establish a high-quality standard for pediatric appendectomy.

Main Methods:

• Comparative analysis of two pediatric patient collectives (>50 children each).
• Evaluation of preoperative parameters (age, sex, anamnesis) and distinct indications.
• Analysis of 350 children undergoing appendectomy, including 54 laparoscopic procedures, focusing on postoperative complications.

Main Results:

• Broader indications for laparoscopic appendectomy (excluding only sonographic perityphlitic abscess) correlated with increased wound healing complications.
• A more rigid indication (excluding acute inflammatory appendicitis) led to fewer complications.
• Laparoscopic procedures in the merged clinic showed significantly fewer complications and better outcomes.

Conclusions:

• Refining the indications for laparoscopic appendectomy in children is crucial for minimizing complications.
• A selective approach to minimally invasive appendectomy improves patient outcomes and quality of life.
• Standardized, evidence-based indications enhance the quality of pediatric surgical care.