Current Status of Laparoscopic Appendectomy in Children: A Nation Wide Survey in Germany

Dingemann, Jens; Metzelder, Martin L.; Szavay, Philipp

doi:10.1055/s-0032-1333121

Cited by 43 publications

(4 citation statements)

References 19 publications

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“…In a national audit conducted in Italy, for example, results confirm the trend of the dissemination of LA to peripheral district hospital: in fact, it is practiced in 93 % of Italian hospitals, and the percentage is increasing [16]. In a national survey conducted in Germany, results show that the technical infrastructure for laparoscopic appendectomy was provided in all units, but only in 79 % of units laparoscopic technique was the standard approach for appendectomy [17]. In a national survey conducted in Massachusetts, among 2565 patients with appendicitis, 90.1 % of appendicitis patients underwent some intervention.…”

Section: Notes On Lap Appendectomymentioning

confidence: 76%

A Worldwide Overview of Emergency Laparoscopic Procedures

Bergamini

Agresta

Campanile

et al. 2016

Emergency Laparoscopy

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Section: Notes On Lap Appendectomymentioning

confidence: 76%

A Worldwide Overview of Emergency Laparoscopic Procedures

Bergamini

Agresta

Campanile

et al. 2016

Emergency Laparoscopy

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“…However, open appendectomy still accounts for a large proportion of appendectomies in children, and despite the predominance of laparoscopic approach in comparable health systems, surgeons in Sweden have been slow to adapt to this trend. [26][27][28][29] In an earlier retrospective single-center study conducted in a Swedish highvolume pediatric surgery institution, laparoscopic appendectomy did not differ from open appendectomy in terms of adverse events within 3 months. 14 Nonetheless, in our population-based study, laparoscopic appendectomy was associated with lower rates of surgical site infections, even when considering the increase in risk related to conversion to open proce-dure.…”

Section: Discussionmentioning

confidence: 99%

A Nationwide Cohort Study of Outcome after Pediatric Appendicitis

et al. 2020

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Introduction Children with appendicitis often present with complicated disease. The aim of this study was to describe the clinical management of pediatric appendicitis, and to report how disease severity and operative modality are associated with short- and long-term risks of adverse outcome. Materials and Methods A nationwide retrospective cohort study of all Swedish children (<18 years) diagnosed with appendicitis, 2001 to 2014 (n = 38,939). Primary and secondary outcomes were length of stay, surgical site infections, readmissions, 30-day mortality, and long-term risk of surgery for small bowel obstruction (SBO). Implications of complicated disease and operative modality were assessed with adjustment for age, gender, and trends over time. Results Complicated appendicitis was associated with longer hospital stay (4 vs. 2 days, p < 0.001), increased risk of surgical site infection (5.9 vs. 2.3%, adjusted odds ratio [aOR]: 2.64 [95% confidence interval, CI: 2.18–3.18], p < 0.001), readmission (5.5 vs. 1.2, aOR: 4.74 [95% CI: 4.08–5.53], p < 0.001), as well as long-term risk of surgery for SBO (0.7 vs. 0.2%, adjusted hazard ratio [aHR]: 3.89 [95% CI: 2.61–5.78], p < 0.001). Intended laparoscopic approach was associated with reduced risk of surgical site infections (2.3 vs. 3.1%, aOR: 0.74 [95% CI: 0.62–0.89], p = 0.001), but no overall reduction in risk for SBO; however, successful laparoscopic appendectomy was associated with less SBO during follow-up compared with open appendectomy (aHR: 0.27 [95% CI: 0.11–0.63], p = 0.002). Conclusion Children treated for complicated appendicitis are at risk of substantial short- and long-term morbidities. Fewer surgical site infections were seen after intended laparoscopic appendectomy, compared with open appendectomy, also when converted procedures were accounted for.

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“…After the laparoscopic revolution in the last 40 years, LA has been widely accepted in most of the developed countries and is now a frequently preferred surgical method. [6] Proper closure of the appendix stump during the LA procedure is important to prevent the development of postoperative complications. The methods used to close the stump in LA include staples, endoloop, titanium clips, non-absorbable polymer clips (hem-o-lock clips), handmade rings, extracorporeal slip knots, intracorporeal suturing as well as energy devices such as LigaSure or bipolar cautery.…”

Section: Discussionmentioning

confidence: 99%

Can laparoscopic appendectomy be safely performed by surgeons who are less experienced in intraabdominal knot-tying?

Bardakci¹

2019

Laparosc Endosc Surg Sci

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Introduction: The aim of this study was to compare the handmade sailor's knot method with the intracorporeal knot method used to close the appendix stump. Materials and Methods: The files of 47 patients who were operated on for acute appendicitis between January 2017 and January 2019 were analyzed retrospectively. The patient records were analyzed in terms of age, gender, type of laparoscopic surgery, length of hospital stay, and postoperative complications. The patients were divided into 2 groups: patients ligated with the sailor's knot method and a prepared loop (Group 1) and intracorporeally ligated patients (Group 2). Results: Of the 47 patients included in the study, 24 were male (51%) and 23 were female (49%). In Group 1, 15 (55.5%) patients were male and 12 (44.5%) patients were female. In Group 2, there were 9 (45%) male patients and 11 (55%) female patients. The mean length of hospitalization of the patients in Group 1 was 3±1.68 days, while it was 2.95±1.13 days in Group 2. The duration of surgery was 73.70±31.76 minutes in Group 1, while it was 70.75±27.25 minutes in Group 2. There was no statistically significant difference between the 2 groups in terms of the length of hospitalization or the duration of surgery. Conclusion: A handmade sailor' knot is an easy, reliable, and cost-effective method to close the appendix stump in patients undergoing laparoscopic appendectomy. The technique can be used safely when intracorporeal knot-tying or suturing cannot be performed.

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Current Status of Laparoscopic Appendectomy in Children: A Nation Wide Survey in Germany

Cited by 43 publications

References 19 publications

A Worldwide Overview of Emergency Laparoscopic Procedures

A Worldwide Overview of Emergency Laparoscopic Procedures

A Nationwide Cohort Study of Outcome after Pediatric Appendicitis

Can laparoscopic appendectomy be safely performed by surgeons who are less experienced in intraabdominal knot-tying?

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