Laparoscopic Appendectomy in Children with Perforated Appendicitis

Abstract

Purpose: It is controversial to do laparoscopic appendectomy in children with perforated appendicitis. Recently, we have adopted laparoscopic appendectomy as a first-choice method in children with perforated appendicitis. We investigate the results of laparoscopic appendectomy in perforated appendicitis and compare it with open technique. Methods: We studied retrospectively the patients who underwent the appendectomy by either a laparoscopic or open technique for perforated appendicitis between January 2001 and December 2005. There were 117 patients in the open appendectomy (OA) group and 45 patients in the laparoscopic (LA) group. Results: The operation times were significantly longer for the LA group than for the OA group (OA group 76.3±23.7 vs. LA group 95.4±32.4 min) (P＜0.05). The hospital days were also longer in the LA group than the OA group (OA group 8.7±4.4 vs. LA group 11.0±6.3 (days)). However, there was no difference in time to diet (OA group: 5.0±3.3 vs. LA group: 5.4±2.9 (days)) (P＞0.05) and in the rate of complications (OA group: 36/117 vs. LA group: 13/45) (P＞0.05) between the two groups. The incidence of postoperative ileus, intraabdominal abscess and wound infection was lower in LA group, but not significantly. Conclusion: Operation times and hospital days were longer in the LA group. But the incidence of complication was similar between the two groups. Considering little postoperative scar and less pain, laparoscopic appendectomy could be regarded as the optimal surgical therapy in children with perforated appendicitis.