Laparoscopic versus open appendectomy in children

Abstract

ObjectiveThe aim of the present work is to compare laparoscopic appendectomy (LA) versus open appendectomy (OA) in children in terms of the following: duration of operation, postoperative pain, analgesic requirement, hospital stay, postoperative complications, and return to normal activities.BackgroundLA is the routine technique used in the management of acute appendicitis in children in many centers. In this study, the classic three-port LA technique is compared with the OA technique in the management of acute appendicitis.Patients and methodsThis was a retrospective study of cases of noncomplicated acute appendicitis treated laparoscopically between February 2011 and February 2012. Patients treated by the laparoscopy and open techniques were compared in terms of the duration of operation, operative and postoperative complications, and the length of hospital stay.ResultsDuring the study period, 40 children (18 males and 22 females) underwent LA or OA for acute appendicitis: 20 children by the laparoscopic technique (group I) and 20 children by the open technique (group II). The mean age of the children was 9.4 years (range 4-18) in group I and 12 years (range 3.5-18) in group II. The mean operative duration was 33.1 min (range 19-45) in group I and 23.7 min in group II (range 14-35). Port-site infection (redness or discharge) was the same in both groups (10%). Postoperative ileus (>48 h) occurred in one patient (5%) in group I and in two patients (10%) in group II. The mean length of hospital stay was 1.8 days in group I and 2.4 days in group II. Two patients in group I were converted to OA (conversion rate 8%).ConclusionLA has the advantage of resulting in less postoperative pain, shorter postoperative ileus, earlier postoperative recovery, lower complication rates, and shorter hospital stay, whereas OA has the advantage of being a shorter procedure.