[Complicated appendicitis in children: laparoscopy or Mac Burney incision?].
OBJECTIVE
The aim of this retrospective study was to compare open (Mc Burney incision group MB n = 92) and laparoscopic (group LAP n = 58) appendectomy for complicated appendicitis (abscess or peritonitis).


METHODS
150 children, with a mean age of 8.5 years, were operated in our department from January 1990 to April 1996. Only children with complicated appendicitis and positive bacteriology of peritoneal fluid were included in this study. All children received parenteral antibiotics for an average of 5.4 days.


RESULTS
The mean operating time was significantly longer in the LAP group (63 vs 43 min p < 0.0001). The conversion rate in the LAP group was 12%. The mean hospital stay was 8.4 days (3-29) without any difference between the 2 groups. There was no significant difference for the complication rate in the 2 groups, except for wound infections which were more frequent in the MB group (p = 0.008). Late postoperative complications occurred in 3 cases in the MB group (none in the LAP group) (NS). There were 2 small bowel obstructions and a wound dehiscence.


CONCLUSIONS
Laparoscopic appendectomy is a safe procedure for complicated appendicitis in children, but the greatest short-term benefit is cosmetic. Long-term results have to be evaluated, particularly with regards to the long-term complication rate.
Plattner
V
V
Service de Chirurgie Infantile, Centre Hospitalo-Universitaire, Hôpital Mère-Enfant, Nantes.
Raffaitin
P
P
Mirallié
E
E
Lejus
C
C
Héloury
Y
Y
D018784:Abdominal Abscess / Q000453:epidemiology; D000293:Adolescent; D001062:Appendectomy / Q000009:adverse effects / Q000379:methods*; D001064:Appendicitis / Q000150:complications / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D010535:Laparoscopy / Q000009:adverse effects; D008297:Male; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000453:epidemiology
Appendicites compliquées de l'enfant: laparoscopie ou Mac Burney?