The prophylactic use of abdominal drainage after laparoscopic appendectomy for perforated appendicitis in children does not prevent postoperative complications and may be associated with negative outcomes. Prospective randomized studies will be necessary to verify this question.

Objective: To investigate the influence of patient age on the diagnosis and management of appendicitis, as well as to evaluate the rate of complications according to the age group.Methods: We undertook a retrospective analysis of 1,736 children who underwent laparoscopic appendectomy in our center between January 2000 and December 2013. Patients were divided in groups taken into account their age: group A were infants, group B were preschoolers, group C were those ones older than five years old, and group D were those ones younger than five years old. A p value of 0.05 was considered statistically significant.Results: We found higher incidence of misdiagnosis and atypical symptoms in the youngest patients. The rate of perforation was similar between group A and B (p=0.17). However, it was higher in group D than in group C (p<0.0001). The incidence of postoperative complications was higher in the youngest patients too (p=0.0002).Conclusions: The age does make a difference in acute appendicitis. Because of its unusual presentation in children younger than five years old, it is often misdiagnosed, which leads to an increased morbidity. Although clinical presentation varies between infants and preschoolers, no statistically significant differences were observed in the rate of perforated appendix or postoperative complications.

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From January 1974 to December 1987, 45 cases of bronchial carcinoid were surgically managed at our Unit, 44 of which were evaluated. All patients but 2 were submitted to fiberoptic bronchoscopy prior to surgery. A standard resection was performed in 19 cases (13 lobectomies, 4 bilobectomies and 2 pneumonectomies). In 11 cases, pulmonary resection was complemented with a bronchoplastic technique (6 lobectomies, 2 bilobectomies, 2 pneumonectomies, 1 segmentectomy). Four cases were managed by minimal resections (2 segmental, 1 wedge, 1 enucleation) and 8 others by bronchotomy and local resection without the sacrifice of lung tissue. There were two major postoperative complications and no operative mortality. Mean follow-up has been 53 months and no local bronchial recurrence has been observed although 2 patients have developed distant metastases, with 1 death. The absence of local recurrence in a series in which more than 50% of patients were treated with some form of conservative surgery seems to indicate that resection of lung tissue should be avoided whenever possible.

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