Abstract
BackgroundAcute complicated appendicitis is a common abdominal emergency in children. Unlike simple appendicitis, laparoscopic appendectomy has not been considered yet the first choice in management of complicated appendicitis. This prospective randomized controlled clinical trial was conducted at Pediatric Surgery Department, Zagazig University Hospitals, Egypt, during the period from December 2018 to August 2019. The aim of the study was to evaluate the role of laparoscopic appendectomy in such cases compared to open appendectomy.ResultsSixty patients were included in the study, divided randomly into 2 equal groups: laparoscopic and open appendectomy groups. The mean operative time was significantly longer with laparoscopic appendectomy than open appendectomy, 85 vs. 61 min, respectively (p < 0.001**). The time taken to start oral intake was significantly shorter with laparoscopic appendectomy than open appendectomy, 1.9 vs. 2.73 days, respectively (p = 0.025*). The mean hospital stay was significantly lower with laparoscopic appendectomy than open appendectomy, 4.23 vs. 5.13, respectively (p = 0.044*). There were no statistical differences between the two groups regarding wound infection, occurrence of postoperative ileus, intraperitoneal collection, or readmission.ConclusionsLaparoscopic appendectomy is safe, feasible, and effective procedure in the management of complicated appendicitis in children, with no evidence of any increase in the postoperative complications.
Highlights
Acute complicated appendicitis is a common abdominal emergency in children
A total of 60 patients were included in the study, 30 of them were managed with Open appendectomy (OA), and the other 30 were managed with laparoscopic appendectomy (LA)
According to the latest update of definition of sepsis, which is a life-threatening organ dysfunction caused by a dysregulated host response to infection [15], there were no cases of sepsis regarding both groups
Summary
Acute complicated appendicitis is a common abdominal emergency in children. Laparoscopic appendectomy has not been considered yet the first choice in management of complicated appendicitis. This prospective randomized controlled clinical trial was conducted at Pediatric Surgery Department, Zagazig University Hospitals, Egypt, during the period from December 2018 to August 2019. Acute appendicitis is considered one of the most common abdominal emergencies in children [1]. Open appendectomy (OA) through McBurney’s incision [4] had been considered as the technique of choice in managing such cases for more than one century. The advantages of laparoscopic appendectomy in complicated appendicitis have been reported by many studies [8,9,10,11]
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