Abstract
Laparoscopic appendectomy for perforated appendicitis in children has the advantages of quick recovery, little influence of inflammatory and oxidative stress and low infection rate. Altogether 115 children with perforated appendicitis treated in our hospital from June 2018 to August 2019 were selected and divided into two groups according to different treatment methods. Laparoscopic appendectomy was used as the research group (RG) (67 cases) and open appendectomy (48 cases) as the control group (CG). The clinical indexes (operation time, intraoperative blood loss, ambulation time, incision length, postoperative exhaust time and length of stay) of the two groups were observed. The levels of C- reactive protein (CRP), procalcitonin (PCT), interleukin -6 (IL-6) and tumor necrosis factor-α (TNF-α) before and after treatment were detected by enzyme-linked immunosorbent assay (ELISA). The levels of oxidative stress factors (superoxide dismutase (SOD), malondialdehyde (MDA)) and the incidence of postoperative incision infection were observed in the two groups. A visual analogue scale (VAS) score was used to evaluate the postoperative pain in children. Logistic regression analysis was used to analyze the risk factors of postoperative incision infection in children. The improvement degree of clinical indicators in RG was significantly better than that in CG. The expression levels of CRP, PCT, IL-6 and TNF-α in RG were significantly lower than those in CG. The expression levels of SOD and MDA in RG were significantly better than those in CG. The postoperative incision infection rate in RG was significantly lower than that in CG. The postoperative VAS score in RG was significantly lower than that in CG. Logistic regression analysis results showed that the risk of incision infection was increased in children with operation time over 1h, incision length >3cm, high CRP, high PCT, high IL-6, high TNF-α, high SOD and low MDA. Laparoscopic appendectomy for perforated appendicitis in children can effectively reduce intraoperative hemorrhage, postoperative pain, and the damage to the body of children, and can also reduce oxidative stress and inflammatory reaction in children.
Highlights
Appendicitis is the most common disease in children undergoing emergency abdominal surgery (1)
Surgery is the main method for clinical treatment of perforated appendicitis (15)
This observation of the impact of laparoscopic and open surgery on clinical indicators of children with perforated appendicitis found that the operation time and intraoperative blood loss of the children in research group (RG) were lower than those in control group (CG), and the postoperative normal activity time, incision length, postoperative exhaust time and length of stay were better than those in CG, indicating that laparoscopic surgery can avoid damage to blood vessels, nerves and muscles of children, which is similar to the research results of Zwintscher NP and XX
Summary
Appendicitis is the most common disease in children undergoing emergency abdominal surgery (1). It is a progressive disease, which is caused by acute inflammation secondary to appendiceal orifice obstruction, leading to necrosis and perforation of the appendix wall. Laparoscopic surgery is a minimally invasive surgery, which is mainly operated by visualization and two-dimensional video obtained by transferring endoscope to body cavity on the screen. It has the advantages of less postoperative complications, high patient satisfaction and fast recovery speed (8). Research has shown that emergencies during surgery will aggravate the balance of patients' cardiovascular and respiratory systems, body fluids and electrolytes, and surgical intervention will lead to inflammatory reactions and blood loss, increasing the physiological pressure of patients (10)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
