Laparoscopic versus conventional appendectomy in children

Abstract

Over a period of 6 months, 48 children who underwent conventional appendectomy (CA) were compared to 34 children who had laparoscopic appendectomy (LA) for acute and recurrent subacute appendicitis. Their ages ranged from 4 to 12 years (mean 8). LA took significantly longer, 76 min, versus 50 min for CA. Less than 2 days' hospitalization was required in 95% of LA cases and 45% of CA cases. Time to return to normal activity averaged 7 days for LA and 12 days for CA (P < 0.001). Wound complications were fewer and the cosmetic appearance was most satisfactory in LA patients. LA is a safe operation that has the advantage of being exploratory, with shorter hospitalization time, early ambulation, and superior cosmetic results.

Transumbilical laparoscopically assisted appendectomy in children

“…The abscess rate was slightly higher in the laparoscopic group, but the difference was not statistically significant. Some studies included in metaanalysis showed less need for postoperative analgesia [11,13,14] and better cosmetic effect [10] as additional advantages of laparoscopy, so the main negative feature of laparoscopic appendectomy remains the higher cost [18]. For that reason, an idea to apply principles and strategies of both procedures and thus compile advantages, resulted in development of laparoscopically assisted techniques.…”

Open and laparoscopic appendectomy are equally safe and acceptable in children

“…In addition, the purported reduction in postoperative pain after laparoscopy has not been confirmed in randomized studies [11]. Laparoscopic appendectomy (LA) does provide the opportunity to evaluate and visualize the entire abdominal cavity in cases of diagnostic dilemmas [7], and with cost-conscious use of reusable instruments, the procedure is no more expensive than its open counterpart [15].…”

Is laparoscopic appendectomy in children associated with an uncommon postoperative complication?

“…Appendectomy is one of the most common intraabdominal surgical procedures in children [7]. Laparoscopic appendectomy (LA), first performed by Semm in 1983 [21], has gained popularity among adult and pediatric surgeons but is still subject to controversy.…”