Abstract
Conservative treatment followed by interval appendectomy has been advocated for appendicitis with abscess formation against urgent appendectomy performed during the acute stage in children. Appendectomy in the presence of an appendiceal abscess is a technically challenging procedure with a high frequency of complications. We have performed interval laparoscopic appendectomy following conservative treatment for appendiceal abscess in 27 children during 11 years since 1999 to 2009. The mean age of the patients was 9.0 ± 3.1 years and their WBC and CRP were 16766 ± 6502/mm3 and 13.1 ± 7.2 mg/dl, respectively. All patients responded to initial conservative treatment and no patients required drainage or appendectomy. The length of initial hospitalization was 15.4 ± 5.3 days. Interval appendectomy could be performed as late as 86.1 ± 40.3 days after symptomatic remission. However, five patients had recurrence before appendectomy. Their symptoms improved by antibiotic therapy. Most of the removed specimens revealed gross structural transformation and chronic inflammation from the histological aspect. There were no significant postoperative complications. Laparoscopic elective appendectomy is a safe and effective method of treatment following conservative treatment for appendicitis with abscess formation in children.
