Clinical analysis of laparoscopic appendectomy for children complicated appendicitis

Abstract

Objective To compare the therapeutic efficacy of laparoscopic appendectomy (LA)with open appendectomy (OA) in children appendicitis complicated with gangrene,perforation and abscess.Methods Total 1008 case of children with appendicitis underwent laparoscopic (LA) (n =472)and open appendectomy (OA) (n =536) in our department between 2004 and 2010.The operative time,wound infection,postoperative intra-abdominal abscess and hospital expenses were targeted to evaluate in both groups.Results There was no mortality in both groups.24 cases of patients in LA group was converted to open procedure and wound (Trocar site) infection rate was significantly lower than that of OA group (6.1％ vs.11.9％,P =0.001).In term of postoperative intra-abdominal abscess,the incidence in LA group was higher than OA group (7.4％ vs.3.7％,P=0.011).Furthermore,the operation time in LA group was longer than OA group (54 ± 12 min vs.53 ± 14 min,P =0.226),and the hospital expenses was more expensive in LA group than in OA group (7305 ± 426RMB vs 7255 ± 435 RMB,P =0.066).Conclusions Laparoscopic appendectomy is a safe and beneficial operative procedure for children with appendicitis.The shorter hospital stay,fast recovery,low incidence of complication rate,as well as better cosmetics can be found in it.However,potential intraabdominal abscess needs to be prevented. Key words: Laparoscopy; Appendectomy; Appendicitis