Laparoscopic versus open appendectomy in complicated appendicitis in children: a single center study

Springer Science and Business Media LLC - 2020
Mohammad Seqsaqa1, Ahmed Ezzat Rozeik1, Mohamed Khalifa1, Hazem Nour Abdellatif Ashri2
1Pediatric Surgery Department, Zagazig University Hospitals, Zagazig, Egypt
2General Surgery Department, Zagazig University Hospitals, Zagazig, Egypt

Tóm tắt

Abstract Background Acute 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. Results Sixty 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. Conclusions Laparoscopic 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.

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Tài liệu tham khảo

Peter SD ST., Wester T. Appendicitis. In: III GWH, Murphy JP, Peter SD St., editors. Holcomb and Ashcraft’s pediatric surgery. 7th China: Elsevier Inc.; 2020. p. 664–678.

Sullins VF, Lee SL. Appendicitis. In: Holcomb GW, Murphy JP, Ostlie DJ, editors. Ashcraft’s pediatric surgery. 6th. Elsevier; 2014. p. 568–579.

Brown RL. Appendicitis. In: Ziegler MM, Azizkhan RG, Men D von A, Weber TR, editors. Operative pediatric surgery. 2nd ed. Mc Graw Hill; 2014. p. 613–631.

McBurney C IV (1894) The incision made in the abdominal wall in cases of appendicitis, with a description of a new method of operating. Ann Surg 20(1):38–43. https://doi.org/10.1097/00000658-189407000-00004

Semm K (1983) Endoscopic appendectomy. Endoscopy. 15(2):59–64

Ure B, Spangenberger W, Hebebrand D, Eypasch E, Troidl H (1992) Laparoscopic surgery in children and adolescents with suspected appendicitis: results of medical technology assessment. Eur J Pediatr Surg 2(06):336–340 Available from: http://www.thieme-connect.de/DOI/DOI?10.1055/s-2008-1063473

Svensson JF, Patkova B, Almström M, Eaton S, Wester T (2016) Outcome after introduction of laparoscopic appendectomy in children: a cohort study. J Pediatr Surg 51(3):449–453. Available from:. https://doi.org/10.1016/j.jpedsurg.2015.10.002

Frazee RC, Bohannon WT (1996) Laparoscopic appendectomy for complicated appendicitis. Arch Surg 131:509–512

Wang X, Zhang W, Yang X, Shao J, Zhou X, Yuan J (2009) Complicated appendicitis in children : is laparoscopic appendectomy appropriate? A comparative study with the open appendectomy — our experience. J Pediatr Surg 44(10):1924–1927. Available from:. https://doi.org/10.1016/j.jpedsurg.2009.03.037

Zwintscher NP, Johnson EK, Martin MJ, Newton CR (2013) Laparoscopy utilization and outcomes for appendicitis in small children. J Pediatr Surg 48(9):1941–1945. Available from:. https://doi.org/10.1016/j.jpedsurg.2012.12.039

Chandler NM, Ghazarian SR, King TM, Danielson PD (2014) Cosmetic outcomes following appendectomy in children: a comparison of surgical techniques. J Laparoendosc Adv Surg Tech 24(8):584–588 Available from: http://online.liebertpub.com/doi/abs/10.1089/lap.2014.0061

Michailidou M, Goldstein SD, Sacco Casamassima MG, Salazar JH, Elliott R, Hundt J et al (2015) Laparoscopic versus open appendectomy in children: the effect of surgical technique on healthcare costs. Am J Surg 210(2):270–275. Available from:. https://doi.org/10.1016/j.amjsurg.2014.09.037

Dai L, Shuai J (2017) Laparoscopic versus open appendectomy in adults and children: a meta-analysis of randomized controlled trials. United European Gastroenterol J 5(4):542–553

Buicko JL, Parreco J, Abel SN, Lopez MA, Sola JE, Perez EA (2017) Pediatric laparoscopic appendectomy, risk factors, and costs associated with nationwide readmissions. J Surg Res 215:245–249. Available from:. https://doi.org/10.1016/j.jss.2017.04.005

Singer M, Deutschman CS, Seymour C, Shankar-Hari M, Annane D, Bauer M et al (2016) The third international consensus definitions for sepsis and septic shock (sepsis-3). JAMA J Am Med Assoc 315(8):801–810

Di Saverio S, Birindelli A, Kelly MD, Catena F, Weber DG, Sartelli M et al (2016) WSES Jerusalem guidelines for diagnosis and treatment of acute appendicitis. World J Emerg Surg 11(34):1–25. Available from:. https://doi.org/10.1186/s13017-016-0090-5

Xuan Z, Glenn L, Bonney K, Bok J, So Y, Lincoln D et al (2019) Laparoscopic versus open appendectomy in pediatric patients with complicated appendicitis : a meta-analysis. Surg Endosc 33(12):4066–4077. Available from:. https://doi.org/10.1007/s00464-019-06709-x

Jaschinski T, Mosch CG, Eikermann M, Neugebauer EAM, Sauerland S (2018) Laparoscopic versus open surgery for suspected appendicitis (Review). Cochrane Database Syst Rev 11:CD001546

Ahuja NR, Rothstein DH (2019) Surgical techniques in pediatric appendectomy. In: Controversies in pediatric appendicitis, Hunter CJ edn. Springer Nature Switzerland AG, pp 103–110

Khirallah MG, Eldesouki NI, Elzanaty AA, Ismail KA, Arafa MA (2017) Laparoscopic versus open appendectomy in children with complicated appendicitis. Ann Pediatr Surg 13:17–20

Tsai C, Lee S, Huang F (2012) Laparoscopic versus open appendectomy in the management of all stages of acute appendicitis in children : a retrospective study. Pediatr Neonatol 53(5):289–294. Available from:. https://doi.org/10.1016/j.pedneo.2012.07.002

Taguchi Y, Komatsu S, Sakamoto E, Norimizu S, Shingu Y, Hasegawa H (2016) Laparoscopic versus open surgery for complicated appendicitis in adults: a randomized controlled trial. Surg Endosc 30(5):1705–1712 Available from: http://link.springer.com/10.1007/s00464-015-4453-x

Horvath P, Lange J, Bachmann R, Struller F, Königsrainer A, Zdichavsky M (2017) Comparison of clinical outcome of laparoscopic versus open appendectomy for complicated appendicitis. Surg Endosc 31(1):199–205 Available from: http://link.springer.com/10.1007/s00464-016-4957-z

Thomson JE, Kruger D, Jann-Kruger C, Kiss A, Omoshoro-Jones JAO, Luvhengo T et al (2015) Laparoscopic versus open surgery for complicated appendicitis : a randomized controlled trial to prove safety. Surg Endosc 29(7):2027–2032

Kassem R, Shreef K, Khalifa M (2017) Effects and clinical outcomes of laparoscopic appendectomy in young children with complicated appendicitis : a case series. Egypt J Surg 36:152–155

Lin H, Lai H, Lai I (2014) Laparoscopic treatment of perforated appendicitis. World J Gastroenterol 20(39):14338–14347

Horwitz JR, Custer MD, May BH, Mehall JR, Lally KP (1997) Should laparoscopic appendectomy be avoided for complicated appendicitis in children? J Pediatr Surg 32(11):1601–1603

Krisher SL, Browne A, Dibbins A, Tkacz N, Curci M (2001) Intra-abdominal abscess after laparoscopic appendectomy for perforated appendicitis. Arch Surg 136(4):438–441

Vahdad MR, Troebs R, Nissen M, Burkhardt LB, Hardwig S, Cernaianu G (2013) Laparoscopic appendectomy for perforated appendicitis in children has complication rates comparable with those of open appendectomy. J Pediatr Surg 48(3):555–561. Available from:. https://doi.org/10.1016/j.jpedsurg.2012.07.066

Chang HK, Han SJ, Choi SH, Oh J (2013) Feasibility of a laparoscopic approach for generalized peritonitis from perforated appendicitis in children. Yonsei Med J 54(6):1478–1483

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