Laparoscopic appendectomy in children with perforated appendicitis

Evan P. Nadler, Kimberly K. Reblock, Faisal G. Qureshi, David J. Hackam, Barbara A. Gaines, Timothy D. Kane

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Purpose: There is persistent controversy regarding the optimal surgical therapy for children with appendicitis. We have recently adopted laparoscopic appendectomy in lieu of the open technique for children with perforated appendicitis. We hypothesized that laparoscopic appendectomy would be as effective as open appendectomy in preventing postoperative complications. Materials and Methods: We reviewed the medical records of children admitted to our hospital over a 5-year period with the diagnosis of perforated appendicitis. Patients were divided into two groups based on the operative approach: laparoscopic vs. open appendectomy. Demographic data, duration of presenting symptoms, initial white blood cell (WBC) count, length of stay, and complications were abstracted. Data were compared using appropriate statistical analyses. Results: There was no difference between the laparoscopic (n = 43) and open (n = 77) groups with respect to gender, duration of presenting symptoms, initial WBC, or length of stay. However, patients in the laparoscopic group had a significantly lower complication rate than those in the open group (6/43 vs. 23/77, P = 0.05). Infectious complications were no different between groups. Patients in the laparoscopic group tended to be older than patients in the open group (10.6 ± 3.3 years vs. 8.5 ± 4.1 years, P = 0.003). Conclusion: Laparoscopic appendectomy for children with perforated appendicitis has the same infectious complication rate and a lower overall complication rate than open appendectomy. A prospective study with standardized postoperative care would be needed to determine whether laparoscopic appendectomy for children with perforated appendicitis is the treatment of choice, but until then it remains an attractive alternative.

Original languageEnglish (US)
Pages (from-to)159-163
Number of pages5
JournalJournal of Laparoendoscopic and Advanced Surgical Techniques
Volume16
Issue number2
DOIs
StatePublished - Apr 1 2006

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Appendectomy
Appendicitis
Length of Stay
Postoperative Care
Leukocyte Count
Medical Records
Leukocytes
Demography
Prospective Studies
Therapeutics

ASJC Scopus subject areas

  • Surgery

Cite this

Laparoscopic appendectomy in children with perforated appendicitis. / Nadler, Evan P.; Reblock, Kimberly K.; Qureshi, Faisal G.; Hackam, David J.; Gaines, Barbara A.; Kane, Timothy D.

In: Journal of Laparoendoscopic and Advanced Surgical Techniques, Vol. 16, No. 2, 01.04.2006, p. 159-163.

Research output: Contribution to journalArticle

Nadler, Evan P. ; Reblock, Kimberly K. ; Qureshi, Faisal G. ; Hackam, David J. ; Gaines, Barbara A. ; Kane, Timothy D. / Laparoscopic appendectomy in children with perforated appendicitis. In: Journal of Laparoendoscopic and Advanced Surgical Techniques. 2006 ; Vol. 16, No. 2. pp. 159-163.
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