Laparoscopic Appendectomy in Children-Indication and Limitation-

Abstract

The aim of this study was to evaluate the outcome of laparoscopic appendectomy (LA) for children (child LA) vs open appendectomy (OA) for children (child OA) and child LA vs LA for adults (adult LA) in patients with appendicitis. Methods : We retrospectively analyzed the clinical records of 1069 patients who had undergone laparoscopic or open appendectomy for appendicitis between May 1995 and Jul 2010 at the Department of Surgery of Juntendo University Urayasu Hospital. Of them, 153 had undergone child LA, 63 child OA, and 605 adult LA. We compared these groups for background factors, and intraoperative and postoperative findings. Results : (Study 1) : child LA vs child OA. Patient demographics were similar in the child LA and child OA groups. Wound infection was significantly more common in the open group at 7.9% than in the laparoscopic group at 1.9% (p<0.05). Hospitalization was significantly shorter in the laparoscopic group (p<0.001). (Study 2) : child LA vs adult LA. Patient demographics were similar in the child LA and adult LA groups. Postoperative course, intra/postoperative complications and conversion rate to the open procedure did not differ significantly between the two groups. Conclusions : Our findings indicate that child LA is safe and useful comparable to child OA or adult LA in treating appendicitis.