Laparoscopic versus open appendectomy in children: retrospective 7-year analysis

Abstract

To evaluate if laparoscopic appendectomy is more favorable than open appendectomy. We included in the study paediatric appendectomy cases from a single institute performed between 2012 and 2018. Patients were divided into two groups: laparoscopic (LA) and open appendectomy (OA, including converted LA). Co-morbidities were excluded. Patients were subdivided according to the histological results as uncomplicated (UCAA—simplex, catharral, phlegmonous) and complicated acute appendicitis (CAA—gangrenous, perforated) cases. Complications (wound healing problems, intra-abdominal abscess, ileus) and length of stay (LOS) were analyzed. For statistical analysis, Fisher’s exact and Chi2 for trend tests were used. Altogether 1027 appendectomies (330 LA, 697 OA) were performed. The mean age at operation was 10.9 years (SD 3.4 years). After LA 26/330 and after OA 65/697 complications were observed. Median LOS in patients after LA was 2 days; whereas following OA, it was 4 (p < 0.0001). In cases of UCAA median LOS was 2 days after LA, but following OA 3 (p < 0.0001). In cases of CAA median LOS was 5.5 days after LA and 7 days following OA, respectively (p = 0.0183). LA and OA are both safe methods in patients with acute appendicitis; however, the LOS is significantly shorter following LA.