Laparoscopic Appendectomy in Complicated Appendicitis of Children

Mohajerzadeh, Leily; Rouzrokh, Mohsen; Tabari, Ahmad Khaleghnejad; Mirshemirani, Alireza; Atqiaee, Khashayar; Dara, Naghi

doi:10.17795/acr-16599

Cited by 7 publications

(5 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…7 Most of the studies concluded that LA was associated with a shorter hospital LOS compared to OA for perforated appendicitis. [5][6][7][8]12,14 In a similar way, this study also shows shorter LOS by 2 days in case of LA compared to OA (5.33±1.826 days vs. 7.30±3.313 days, p = 0.005).Different studies have found that the infection rate is low in LA patient in comparison to OA case. [8][9][10][11][12][13][14] Similarly this study also revealed that the less infection rates in LA (5 in 30 patients = 16 %) compared to OA (12 in 30 patients = 40 %) with p = 0.042.…”

Section: Discussionsupporting

confidence: 71%

“…It is associated with a considerably shorter LOHS, lower incidence of wound infection, and reduced postoperative pain and faster recovery compared with OA. 6,7 Though many controversies exist regarding the most favorable management modality of patients with appendicular perforation. 6 In this study, the total number of appendectomy was 318 during the study period among which 60 patients (18.86 %) were diagnosed as having perforated appendicitis.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Perforated Appendicitis Treated By Open Versus Laparoscopic Surgery- A Comparative Study

Timilsina¹,

Karki²,

Subedi³

2021

Nep. Mediciti Med. J.

View full text Add to dashboard Cite

Background: Acute appendicitis is the most common surgical emergency of the abdomen. Perforated appendicitis often has higher morbidity and mortality. Laparoscopic Appendectomy (LA) is safe and effective procedure for the simple appendicitis compared to Open Appendectomy (OA) but it is not considered as the first line approach in case of perforated appendicitis and its role is still controversial and is under investigation. Hence this study was carried out to compare the outcomes of LA over OA in proven cases of perforated appendicitis. Methods: A hospital based comparative study was conducted among 60 patients with the diagnosis of perforated appendicitis who underwent LA and OA, for a duration of 18 months in Manipal Teaching Hospital, Pokhara. Data were collected using semi-structured questionnaire and were analyzed by descriptive and inferential statistics with SPSS version 25.0. Results: The study showed no significant statistical difference in operative time in LA compared to OA (66±18.11 minutes vs. 66.67±25.269 minutes, p = 0.9). Moreover it shows less post-operative pain (p = 0.003), shorter length of hospital stay (5.3±1.8 days vs. 7.3±3.31 days, p = 0.005), faster return of peristalsis (1.43±0.504 days vs 1.80±0.805 days, p = 0.037) and faster reinstitution of liquid diet(1.43±0.504 days vs 1.80±0.805 days, p = 0.037), less incidence of wound infection (5 in 30 = 16.66% vs. 12 in 30 = 40%, p = 0.042) and faster subjective full recovery(1.9±0.759 weeks vs. 2.9±0.89 weeks, p ˂ 0.0001) of LA patient compared to OA which is statistically significant. Conclusion: LA is safe and effective procedure than OA for perforated appendicitis.

show abstract

Section: Discussionsupporting

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Perforated Appendicitis Treated By Open Versus Laparoscopic Surgery- A Comparative Study

Timilsina¹,

Karki²,

Subedi³

2021

Nep. Mediciti Med. J.

View full text Add to dashboard Cite

show abstract

“…Further, CT is suggested to be helpful in children with moderate scores and vague US results (18)(19)(20). The negative appendectomy and complicated appendicitis rates are both vital for superiority measures of the management of appendicitis, especially in children (21,22). On the other hand, these two items have an opposite correlation.…”

Section: Discussionmentioning

confidence: 99%

Is Alvarado Score Helpful for Pediatrician in Diagnosis of Acute Appendicitis? Our Center Experience

Tabatabaei

Karimi

Nassiri

et al. 2021

Arch Pediatr Infect Dis

Self Cite

View full text Add to dashboard Cite

Background: Many problems in the diagnosis of patients with suspected appendicitis have led to the design of clinical scoring systems. In children, diagnostics tools for appendicitis are more critical. Younger patients, diagnostic challenges become more. Practical scoring systems are useful without any particular material and necessitate novel ability. Objectives: However, in spite of the reported outstanding consequences, these scoring systems are not employed regularly. Methods: In this cross-sectional study performed from October 2016 to October 2017, ten provinces out of the 31 provinces in Iran were randomly selected. A total of 631 patients referring to the hospitals with the suspicion of acute appendicitis were assessed. Related variables such as age, sex, right lower quadrant (RLQ) pain, migration of pain to RLQ, nausea, and presence of vomiting, anorexia, tenderness in RLQ and guarding, presence of rebound tenderness, and degree of fever were taken from recorded files by pediatricians. Alvarado scoring system was used for included cases to assess the accuracy of this test for diagnosis of appendicitis in our centers. Results: The mean age of eligible patients was 9.3 ± 3.21 years ranged from 3 years to 18 years, and 380 (60.5%) were male. Using the Alvarado score system in this study, considering the cut-off point value of 7 to decide for operation, the positive predictive value (PPV) showed 32.6%, and negative predictive value (NPV) was 76.73%, with a sensitivity of 44.05% and, specificity of 66.95%. There were statistically no significant correlations among the scoring of the Alvarado and diagnosis of AA (P < 0.05). Regarding receiver operator characteristic curves (ROC), the area under curve (AUC) was 0.58 (0.54 to 0.63) for Alvarado. The AUC was very low, so there was no value for the diagnosis of appendicitis. According to the findings of the present study, the cut-off point of 4.5 is suggested for the diagnosis of acute appendicitis in children with a sensitivity of 73% and specificity of 58%. Conclusions: Although the Alvarado scores supply obviously practical diagnostic information in the management of pediatric population with supposed appendicitis, this method delivers no adequate PPV for clinical practice as a safe way for determining necessary operation.

show abstract

“…Other studies have reported a longer or shorter operative time [17][18][19] . This difference could be attributed to the difference in the level of laparoscopist's skills.In this study, the conversion rate was 4.7%, which nearly matches that reported in other studies 20.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Laparoscopic Appendectomy for Complicated Appendicitis in Children in Tertiary Care Hospital

Anisuzzaman¹,

Kabir²,

Sadiq³

et al. 2018

J Med Sci Res

View full text Add to dashboard Cite

Laparoscopic appendectomy for uncomplicated appendicitis is associated with good outcomes but the role of laparoscopy in complicated appendicitis is more controversial because of high incidence of infectious complications. The aim of this current study is to evaluate the efficacy and safety of laparoscopic appendectomy in complicated appendicitis in children. This interventional study was carried out during the period from January 2015 to May 2018 in Holy Family Red Crescent Medical College Hospital. The study included 43 patients, age ranges from 3 years to 15 years who underwent laparoscopic appendectomy for complicated acute appendicitis. The following variables were analyzed : age, sex, operative findings, operative time, return of bowel function, resumption of oral feeds, length of hospital stay, postoperative complications such as deur, wound infection and intraabdominal abscess etc. The mean age of studied cases was 7.1 years. In 41 patients (95.3%) the procedure was completed laparoscopically. Two (4.7%) patients required conversion to open appendectomy. The operative time was 83.5+,25.8 minutes. Two patients (4.6%) had post-operative ileus. Four patients (9.7%) developed superficial wound infection. Three patients (7.3%) developed infra-abdominal collections. One (2.4%) patients were readmitted because of recurrent abdominal pain One patients (2.4%) developed postoperative pyrexia due to pneumonitis and Three patients (7.3) developed gastroenteritis. The mean length of hospital stay was 5.8±2.1 days. No mortality was recorded.Laparoscopic appendectomy can be the first choice for cases of complicated appendicitis in children. It is a feasible, safe procedure and is associated with acceptable post-operative morbidity with rapid recovery and better cosmetic results.

show abstract

Laparoscopic Appendectomy in Complicated Appendicitis of Children

Cited by 7 publications

References 16 publications

Perforated Appendicitis Treated By Open Versus Laparoscopic Surgery- A Comparative Study

Perforated Appendicitis Treated By Open Versus Laparoscopic Surgery- A Comparative Study

Is Alvarado Score Helpful for Pediatrician in Diagnosis of Acute Appendicitis? Our Center Experience

Efficacy and Safety of Laparoscopic Appendectomy for Complicated Appendicitis in Children in Tertiary Care Hospital

Contact Info

Product

Resources

About