Laparoscopic Appendectomy for Simple and Complicated Appendicitis in Children—Safe or Risky Procedure

Abstract

Laparoscopic appendectomy is good alternative for classic appendectomy, irrespective of the degree of inflammation. Accurate cleaning and rinsing of the abdominal cavity essentially decreases the quantity of complications even in cases with perforated appendicitis. This suggests the expansion of indications toward laparoscopic appendectomy in case of all children with acute appendicitis.

Outcomes After Laparoscopic Treatment of Complicated Versus Uncomplicated Acute Appendicitis: A Prospective, Comparative Trial

“…This difference was entirely based on persistent postoperative fever in the CAA group, since no significant differences were found in the number of intra-abdominal abscesses or noninfectious complications in this study. Previous studies have reported greater risk of intra-abdominal abscessses in CAA patients, 11 which was not found in our series.…”

“…In both open and laparoscopic apendicectomy, it is accepted that the greater the degree of evolution of AA, the worse the short-term results and the higher the rate of infectious complications. However, few published reports 11 have addressed to what extent the degree of evolution of AA affects the results of laparoscopic appendectomy and what variables are most affected on comparing treated cases of uncomplicated versus complicated AA. This was the aim of the present study.…”

Laparoscopic Appendectomy in Children with Complicated Appendicitis: Ethnic Disparity Amid Changing Trend

“…As earlier stated, the overall mortality in the study population was very low at 0.04% (4/10,000 appendectomies) and the difference between the two arms may have no clinical significance. Moreover, several studies have demonstrated a 0% mortality when LA is employed in the management of complicated appendicitis [10][11][12][19][20][21][22]. A more relevant outcome of interest is [14].…”

“…Initial results were very controversial, with concerns about intra-abdominal abscess (IAA) with LA compared with OA, though other studies disagreed with the finding [8,9]. Subsequent studies have, however, disproved the concerns about increased postoperative complications in complicated appendicitis, with some demonstrating lower complications, length of hospital stay, and need for fewer followup visit with LA [10][11][12][13][14][15][16][17]. While most of the studies were small in size and retrospective in nature, they strongly suggest that outcomes following LA for complicated appendicitis are not inferior to those obtained with OA.…”

Laparoscopic appendectomy for acute appendicitis: Is this a feasible option for developing countries?

“…A number of recent reports, however, question this approach and the results indicate that patients with complicated appendicitis may be as effectively managed by laparoscopic approach. [31–33]Further randomized trials might help resolve this issue.…”