Open Versus Laparoscopic Appendectomy in the Pediatric Population: A Literature Review and Analysis of Complications

Esposito, Ciro; Calvo, Andres Ignacio; Castagnetti, Marco; Alicchio, Francesca; Suárez, Carlos; Giurin, Ida; Settimi, Alessandro

doi:10.1089/lap.2011.0492

Cited by 72 publications

(51 citation statements)

References 22 publications

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“…71 A recent Cochrane review, and a pediatric-focused literature review, recommended that the laparoscopic approach be used unless there is a contraindication. 72,73 While some surgeons may prefer an open approach in children with perforated appendicitis, previous studies have suggested that complication rates in this population may be no different with the use of laparoscopy compared to the open technique. 74 Despite variations in practice, the overall negative appendectomy rate in our study was low; the majority of sites had rates of less than 5%, although variation certainly exists.…”

Section: Discussionmentioning

confidence: 99%

Variation in the Diagnosis and Management of Appendicitis at Canadian Pediatric Hospitals

et al. 2015

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Objectives: The objective was to characterize the variations in practice in the diagnosis and management of children admitted to hospitals from Canadian pediatric emergency departments (EDs) with suspected appendicitis, specifically the timing of surgical intervention, ED investigations, and management strategies.Methods: Twelve sites participated in this retrospective health record review. Children aged 3 to 17 years admitted to the hospital with suspected appendicitis were eligible. Site-specific demographics, investigations, and interventions performed were recorded and compared. Factors associated with afterhours surgery were determined using generalized estimating equations logistic regression.Results: Of the 619 children meeting eligibility criteria, surgical intervention was performed in 547 (88%). After-hours surgery occurred in 76 of the 547 children, with significant variation across sites (13.9%, 95% confidence interval = 7.1% to 21.6%, p < 0.001). The overall perforation rate was 17.4% (95 of 547), and the negative appendectomy rate was 6.8% (37 of 547), varying across sites (p = 0.004 and p = 0.036, respectively). Use of inflammatory markers (p < 0.001), blood cultures (p < 0.001), ultrasound (p = 0.001), and computed tomography (p = 0.001) also varied by site. ED administration of narcotic analgesia and antibiotics varied across sites (p < 0.001 and p = 0.001, respectively), as did the type of surgical approach (p < 0.001). After-hours triage had a significant inverse association with after-hours surgery (p = 0.014).Conclusions: Across Canadian pediatric EDs, there exists significant variation in the diagnosis and management of children with suspected appendicitis. These results indicate that the best diagnostic and management strategies remain unclear and support the need for future prospective, multicenter studies to identify strategies associated with optimal patient outcomes.ACADEMIC EMERGENCY MEDICINE 2015;22:811-822 © 2015 by the Society for Academic Emergency Medicine A ppendicitis is the most common nontraumatic surgical emergency in children, 1,2 yet it continues to present diagnostic and management uncertainty.3 Current strategies for diagnosing appendicitis include the use of clinical scoring systems, 4-7 laboratory markers of infection and inflammation, [8][9][10] and

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Section: Discussionmentioning

confidence: 99%

Variation in the Diagnosis and Management of Appendicitis at Canadian Pediatric Hospitals

et al. 2015

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“…Laparoscopic versus open appendectomy in pediatric appendicitis has been studied extensively [16e22]. Several studies have demonstrated that the laparoscopic approach is associated with shorter LOS [16e21] and earlier recovery [20,22]. The safety, efficacy, and advantages of laparoscopy in complicated appendicitis have also been established [17,18,20e23] and are similar to those of uncomplicated appendicitis.…”

Section: Discussionmentioning

confidence: 99%

Variability in same-day discharge for pediatric appendicitis

Oyetunji

Gonzalez

Aguayo

et al. 2015

Journal of Surgical Research

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“…Laparoscopic appendicectomy has since become the most common surgical technique for treating acute appendicitis in children 3 . This shift in practice has been attributed to shorter lengths of hospital stay, earlier return to normal function, and a better cosmetic appearance 4 . However, whether the post‐operative outcomes of laparoscopic appendicectomy are equivalent to those of traditional open appendicectomy is still debated, particularly in cases of complicated appendicitis.…”

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confidence: 99%

A population‐based comparison of the post‐operative outcomes of open and laparoscopic appendicectomy in children

Schneuer

Adams

Bentley

et al. 2018

Medical Journal of Australia

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Open Versus Laparoscopic Appendectomy in the Pediatric Population: A Literature Review and Analysis of Complications

Cited by 72 publications

References 22 publications

Variation in the Diagnosis and Management of Appendicitis at Canadian Pediatric Hospitals

Variation in the Diagnosis and Management of Appendicitis at Canadian Pediatric Hospitals

Variability in same-day discharge for pediatric appendicitis

A population‐based comparison of the post‐operative outcomes of open and laparoscopic appendicectomy in children

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