Abstract
Purpose: To investigate the benefit of the single incision laparoscopic surgery (TANKO) in the treatment of pediatric appendicitis, we conducted a comparison study between TANKO and conventional three-port laparoscopic appendectomy (CLA).
Methods: Of 40 consecutive pediatric patients who underwent laparoscopic appendectomy for the last four years, 15 were performed with CLA, and the remaining 25 with TANKO including three methods of different concepts; transumbilical laparoscopy-assisted appendectomy, total laparoscopic appendectomy, and so-called hybrid TANKO. The severity of the disease, operative time, hospital stay, complications, and satisfaction of the scar, were retrospectively compared.
Results: The successful ratios were 100% in CLA and 88% in TANKO. There were four children with complicated appendicitis (CA) in the CLA group, while none in the successful TANKO group. The operative time of TANKO group was significantly shorter than that of CLA group; however, those treated by the total laparoscopic TANKO appendectomy needed a duration similar to that of CLA group. Although the significance disappeared when CA patients were excluded, hospital stay of the TANKO group was shorter than the CLA group. Most patients of both groups had no complications, and were satisfied with their scars, except one boy in the TANKO group who complained of reoperation for his deformed umbilics.
Conclusions: Our data suggest that TANKO appendectomy is applicable and useful in pediatric patients, and is not inferior to CLA. In TANKO, however, additional ports should be placed without hesitation in a difficult case such as CA, and it is necessary to pay enough attentions to prevent postoperative deformation of the umbilicus.
