Single-blind randomized clinical trial of laparoscopic versus open appendicectomy in children.
BACKGROUND
Appendicectomy is the most common emergency surgical operation in children. The aim of this study was to compare recovery after appendicectomy using either a laparoscopic or an open technique in children.


METHODS
Sixty-one children aged 4-15 years undergoing appendicectomy for suspected uncomplicated appendicitis were studied. The study was prospective, randomized and single-blinded, with parallel groups. Standardized anaesthetic technique and pain management were used. The study endpoints were postoperative pain, need for rescue analgesia, and length of hospital stay.


RESULTS
Children had significantly less pain after laparoscopic compared with open appendicectomy 8 h after operation and on the first and second postoperative mornings (P < 0.05). Laparoscopic appendicectomy resulted in a reduced requirement for rescue analgesia with oxycodone in hospital: mean(s.d.) 3.6(2.5) versus 5.8(3.3) doses (mean difference 2.2 doses, 95 per cent confidence interval (c.i.) 0.6--3.8 doses); P = 0.01. The mean(s.d.) length of hospital stay was significantly shorter in the laparoscopic group: 1.9(0.7) versus 2.6(0.9) days (mean difference 0.7 days, 95 per cent c.i. 0.3--1.1 days); P = 0.001. Three children who had open appendicectomy developed a wound infection.


CONCLUSIONS
Laparoscopic appendicectomy is associated with less postoperative pain and a shorter hospital stay than open appendicectomy in children undergoing surgery for uncomplicated appendicitis.
Lintula
H
H
Department of Paediatric Surgery, Kuopio University Hospital, PO Box 1777, FIN-70211 Kuopio, Finland.
Kokki
H
H
Vanamo
K
K
D000293:Adolescent; D001062:Appendectomy / Q000009:adverse effects / Q000379:methods*; D001064:Appendicitis / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006699:Home Care Services; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay; D008297:Male; D010149:Postoperative Pain / Q000209:etiology; D011182:Postoperative Care; D011446:Prospective Studies; D016037:Single-Blind Method