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Introduction: Laparoscopic appendectomy (LA) for complicated appendicitis appears to be controversial due to the difficulty in dissection and clearing off the peritoneal contamination, prolonged operating times, higher incidence of post-operative abdominal abscess, and wound infections. Objectives: The objective of the study was to compare laparoscopic and open appendectomy (OA) and evaluate the outcome of LA in children with complicated appendicitis. Materials and Methods: A retrospective analysis of 182 patients’ records with complicated appendicitis was done. Data collected included demographics, operative time, resumption of oral intake, and infectious complications such as wound infection and intra-abdominal abscess, need for redo surgery, length of hospitalization, and duration of antibiotic use. Patients were followed up for 6 months in the post-operative period to assess delayed complications. Results: LA was performed in 102 patients and 80 patients underwent an OA. The two groups did not differ significantly in mean age, duration of antibiotic use, resumption of oral intake, and length of the hospital stay. The duration of surgery was significantly longer for LA (p<0.0001). However, the wound infection was significantly more common in the OA group than the laparoscopy group (p=0.0058). None of the patients in the LA group developed delayed complications. A total of four patients in the open group had to undergo surgery for late-onset complications. Conclusion: LA for complicated appendicitis is more advantageous than OA as there is reduced surgical site infection. However, the operative time is prolonged with an increased incidence of immediate post-operative intestinal obstruction. Nevertheless, it avoids the late complications of OA.

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Background: The management of vesicoureteric reflux (VUR) has undergone a radical change from initial ureteric reimplantation to a more conservative approach. Several studies have demonstrated the validity of this concept by evaluating the role of antibiotic prophylaxis. Recent randomized trials have shown no proven benefits of long-term antibiotic prophylaxis. Objective: The objective of this article is to review the outcome of conservative management of VUR with antibiotic prophylaxis over a period of 2-year. Materials and Methods: A prospective observational study for 2 years was performed in children with primary reflux. They were given continuous antibiotic prophylaxis and regularly followed up every 3 months. Relevant investigations were performed at every follow-up including monitoring of growth parameters. Outcome in terms of recurrent urinary tract infection (UTI) episodes, resolution of VUR, need for definitive surgery were analyzed. Results: Out of initial 48 patients enrolled in the study, three patients were lost for follow-up. Out of 45 patients (77 renal units), most of the patients had Grade III and IV reflux. Scarring was seen predominantly in Grade IV reflux (62.5%). At the end of 2 years, no units demonstrated Grade I reflux. Grade II reflux persisted in 16.67%. Grade III reflux persisted in 23.68%, while Grade IV reflux persisted in 62.5%. Most of the fresh UTI episodes occurred in Grade III and IV VUR patients. Fresh renal scars were seen mostly in Grade IV group. One patient underwent ureteric reimplantation due to fresh renal scar and persistent reflux. Conclusions: Conservative management of VUR with antibiotic prophylaxis appears to be a suitable option without adverse outcomes. In the current scenario, surgery has a minor role to play in the treatment of VUR..