Laparoscopic versus open appendectomy in children with uncomplicated and complicated appendicitis

Ikeda, Hitoshi; Ishimaru, Yuki; Takayasu, Hajime; Okamura, Kaori; Kisaki, Yoshiyuki; Fujino, Junko

doi:10.1016/j.jpedsurg.2004.07.018

Cited by 89 publications

(88 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…There are also studies showing that the surgery time decreases with more training in the laparoscopic technique [15]. However, our study did not show any difference in the surgery time between the two methods.…”

Section: Discussioncontrasting

confidence: 80%

“…Previous studies have shown the opposite pattern, with more postoperative intra-abdominal abscesses occurring with LA [10]. In the present study, children in the OA group had a significantly higher rate of complicated appendicitis, which surely explains this result; complicated appendicitis is more likely to lead to postoperative complications [15]. Therefore, the higher incidence of intra-abdominal abscesses in the open group may be due to a selection bias and not an actual difference between the two techniques.…”

Section: Discussionsupporting

confidence: 43%

“…No significant differences were seen for gangrenous and perforated appendicitis and for appendiceal abscesses. Previous studies have shown that the hospital stay is decreased when LA is performed in all subgroups of both complicated and uncomplicated appendicitis [15,17]. All inflammation groups treated with OA had a longer hospital stay, but the Phlegmonous appendicitis group was the only one with a significant difference.…”

Section: Discussionmentioning

confidence: 83%

“…Previous studies have shown that the longer operating time for LA can result from lack of experience in the technique. This difference will decrease as surgeons receive more training in endoscopic surgery [15].…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Laparoscopic or Open Appendectomy for Pediatric Appendicitis?

Elofsson¹,

Gemryd²,

Arnbjörnsson³

et al. 2016

MOJS

View full text Add to dashboard Cite

Background: This study aimed to compare open appendectomy (OA) and laparoscopic appendectomy (LA) in children by analyzing the differences in outcomes between the two techniques. Materials and Methods:This was a single-institution retrospective study. Data were collected from the medical records of all children <15 years of age who underwent an appendectomy from 2006 through 2014. Preoperative parameters, appendicitis severity, surgery time, complications, pain treatment, and postoperative outcome including days of hospital stay were collected. LA was performed with a two-or three-port technique, and a McBurney incision was adopted for OA. Conversions were regarded as OA.Results: A total of 406 appendectomies were performed during the study period, 146 (36%) OA (61 conversions) and 260 (64%) LA. No differences were found between the two groups regarding surgery time, operative and postoperative complications, and postoperative pain treatment. In cases of Phlegmonous appendicitis, LA was associated with a significantly shorter median hospital stay than was OA (1 and 1.8 days, respectively; p < 0.01). Healthy and Phlegmonous appendices were more commonly treated with LA (p < 0.01 for both); gangrenous, perforated, and abscessed appendices were more commonly treated with open surgery (p = 0.02, p < 0.01, and p < 0.01, respectively). Conclusion:The study identified no disadvantages of LA compared with OA. Therefore, LA should be the preferred technique because it is associated with a shorter hospital stay for patients with Phlegmonous appendicitis and also allows inspection of the abdominal cavity, a major diagnostic advantage. result from lack of experience in the technique. This difference will decrease as surgeons receive more training in endoscopic surgery [15]. Keywords:Since the introduction of LA the use of this surgical method has increased, making it the method of first choice [9]. The long transition period and the continued use of both techniques are due to the split opinion among surgeons and the lack of experience in endoscopic surgery [9]. According to a 2008 national cohort study of children and adults, 33% of appendectomies began as LA and 66% began as OA [16]. In 1992, the rate of intended LA was only 4%; prior to that year the procedure was performed only sporadically [16]. In patients aged 0-9 years, 4% of appendectomies performed from 1992 to 2008 were laparoscopic; in those aged 10-19 years, the rate was 18% [16]. LA was performed less commonly in children than in the population as a whole (the LA rate for the total population from 1992 to 2008 was 20%) [16].The aim of this study was to compare OA and LA in children with regard to perioperative parameters and postoperative outcome. The intention was to provide information of value to surgeons making the decision to perform appendectomy for a child. The question is whether LA or OA leads to the better outcome when treating pediatric appendicitis. Materials and Methods Settings and childrenAll children underwent surgery at the Department o...

show abstract

Section: Discussioncontrasting

confidence: 80%

Section: Discussionsupporting

confidence: 43%

Section: Discussionmentioning

confidence: 83%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Laparoscopic or Open Appendectomy for Pediatric Appendicitis?

Elofsson¹,

Gemryd²,

Arnbjörnsson³

et al. 2016

MOJS

View full text Add to dashboard Cite

show abstract

“…The duration of laparoscopic surgery was longer than open appendectomy [18]. In contrast to the Ikeda et al study, we only included uncomplicated cases of appendicitis.…”

Section: Discussionmentioning

confidence: 99%

Changes in levels of C-reactive protein in open appendectomy compared to laparoscopic appendectomy

Askarpour¹,

Asgari²,

Hashemi³

et al. 2012

View full text Add to dashboard Cite

Aim: The aim of this study was to compare post-operative C-reactive protein (CRP) between cases which underwent open appendectomy and laparoscopic appendectomy. Material and methods: This study was conducted on patients admitted for appendectomy in Imam Khomeini and Razi hospitals. Patients with perforated and gangrenous appendicitis, another pathological condition, renal failure, liver failure, history of taking drugs that interact with C-reactive protein (CRP), and pregnancy were excluded from this study. Cases were divided into children (5-15 years) and adults (16-65 years). Patients were randomly selected for open or laparoscopic appendectomy. SPSS version 16.0 (SPSS Inc, Chicago, IL, USA) was used for data analysis. T-test was used for comparison. Pearson and Spearman tests were used for correlation analysis. Results: There were no significant differences between CRP levels after laparoscopy in children vs. adult cases (p-value > 0.05, t-test). There was no significant difference between children and adults in pre-op CRP. There were significant differences between children and adults for 12 h and 24 h level of CRP after laparoscopic appendectomy (p < 0.05, t-test). Mean level of CRP in adults was significantly higher than children (p < 0.05, t-test). Level of CRP, 12 h after the procedure, was significantly higher in open appendectomy compared to laparoscopic surgery in adult cases (p = 0.09, t-test). In cases with body mass index (BMI) < 25 kg/m 2 , there was no significant difference between level of CRP before and after open or laparoscopic surgery. In cases with BMI ≥ 25 kg/m 2 , there was no significant difference between level of CRP of open and laparoscopic surgery (p > 0.05, t-test). Duration of surgery had no effect on level of CRP (p > 0.05, t-test). Conclusions: There was no significant difference between level of CRP after open and laparoscopic appendectomy, except in adult women. Level of CRP, 12 h and 24 h after surgery, was significantly higher in adult cases than children.

show abstract