Laparoscopic appendectomy in children: A favorable alternative in simple and complicated appendicitis

Meguerditchian, Ari-Nareg; Prasil, Pascale; Galvez‐Cloutier, Rosa; Leclerc, Suzanne; Péloquin, Jean; Roy, G.

doi:10.1053/jpsu.2002.32255

Cited by 91 publications

(82 citation statements)

References 17 publications

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“…Laparoscopic appendectomy has been reported to have advantages when compared with the open approach, including faster recovery time, less scarring, shorter postoperative hospitalization, and a decreased incidence of small bowel obstruction [11][12][13]. Others have found no benefit for the laparoscopic approach [14].…”

Section: Discussionmentioning

confidence: 99%

Resource utilization and outcomes from percutaneous drainage and interval appendectomy for perforated appendicitis with abscess

Keckler

Tsao

Sharp

et al. 2008

Journal of Pediatric Surgery

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Objective-Given the perceived technical demands of laparoscopic appendectomy and the expected postoperative morbidity in patients with a well-defined abscess, initial percutaneous drainage has become an attractive option in this patient population. This strategy allows for a laparoscopic appendectomy to be performed in an elective manner at the convenience of the surgeon. However, the medical burden on the patient and on the quality of patient outcomes has not been described in the literature. Therefore, we audited our experience with initial percutaneous drainage followed by laparoscopic interval appendectomy to evaluate the need for a prospective trial.Methods-After institutional review board approval, a retrospective chart review was performed on all children who presented with perforated appendicitis and a well-defined abscess and were treated by initial percutaneous aspiration/drainage followed by interval appendectomy between January 2000 and September 2006. Continuous variables are listed with standard deviation.Results-There were 52 patients with a mean age of 9.0 ± 3.9 years and weight of 34.4 ± 18.8 kg. The mean duration of symptoms at presentation was 8.4 ± 7.6 days. Percutaneous aspiration only was performed in 2 patients. The mean volume of fluid on initial aspiration/drain placement was 76.3 ± 81.1 mL. The mean time to appendectomy was 61.9 ± 25.2 days. The laparoscopic approach was used in 49 patients (94.2%), of which one was converted to an open operation. The mean length of hospitalization after interval appendectomy was 1.4 ± 1.4 days. A recurrent abscess developed in 17.3% of the patients. Six patients (11.5%) required another drainage procedure. The mean total charge to the patients was $40,414.02. There were 4 significant drain complications (ileal perforation, colon perforation, bladder perforation, and buttock/thigh necrotizing abscess).The child with the ileal perforation after drain placement is the only patient who failed initial nonoperative therapy.Conclusions-The use of initial percutaneous aspiration/drainage of periappendiceal abscess followed by interval appendectomy is an effective approach. However, this management poses complication risks and uses considerable resources. Therefore, this strategy should be compared with early operation in a prospective trial.

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Section: Discussionmentioning

confidence: 99%

Resource utilization and outcomes from percutaneous drainage and interval appendectomy for perforated appendicitis with abscess

Keckler

Tsao

Sharp

et al. 2008

Journal of Pediatric Surgery

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“…24 There are four recent large published comparative series of laparoscopic appendicectomy in children with their data summarised in Table 1. [25][26][27][28] All are largely observational and not subject to the rigours of a prospective randomised trial. There are four smaller-scale randomised trials in 43 children from Finland, 29 63 children from France, 30 88 children from the US, 31 and 61 children from Finland 32 also summarised in Table 1.…”

Section: Laparoscopic Appendicectomymentioning

confidence: 99%

“…However, no such difference has been found in other large, observational studies. 26,28 LA is typically performed using 3 (or 4) ports, one 10-mm umbilical port for the videoscope and for extraction and 2 (or 3), 5-mm working ports placed in the right upper quadrant and suprapubic (or left iliac fossa if small child). Three methods of amputating the appendix have been described in children: stapling (using the EndoGIA, Ethicon Endosurgery), ligation (using an endoloop) or laparoscopicassisted extracorporeal appendicectomy (through the umbilical wound).…”

Section: Laparoscopic Appendicectomymentioning

confidence: 99%

Laparoscopic surgery in children

Davenport¹

2003

ann r coll surg engl

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“…Many studies suggested that LA decreases the rate of superficial surgical site infection and length of stay and provides earlier enteral feeding, with better cosmetic results both in NCA, and CA. LA has some additional advantages over OA, such as improved visualisation of the peritoneal cavity (13,14).…”

Section: Discussionmentioning

confidence: 99%

The Comparison Of The Open And Laparoscopic Appendectomy: Is There Any Outcome Difference Between Non-complicated And Complicated Appendicisit?

Bıçakçı¹,

Tander²,

Günaydın³

et al. 2010

TUTFD

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Laparoscopic appendectomy in children: A favorable alternative in simple and complicated appendicitis

Cited by 91 publications

References 17 publications

Resource utilization and outcomes from percutaneous drainage and interval appendectomy for perforated appendicitis with abscess

Resource utilization and outcomes from percutaneous drainage and interval appendectomy for perforated appendicitis with abscess

Laparoscopic surgery in children

The Comparison Of The Open And Laparoscopic Appendectomy: Is There Any Outcome Difference Between Non-complicated And Complicated Appendicisit?

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