Open and laparoscopic appendectomy are equally safe and acceptable in children.
BACKGROUND
The aim of this study was to evaluate prospectively whether laparoscopic (LA) and open appendectomy (OA) are equally safe and feasible in the treatment of pediatric appendicitis.


METHODS
A total of 517 children with acute appendicitis were randomly assigned to undergo LA or OA appendectomy, based on the schedule of the attending surgeon on call. Patient age, sex, postoperative diagnosis, operating time, level of training of surgical resident, length of postoperative hospitalization, and minor and major postoperative complications were recorded. Chi-square analysis and the Student t-test were used for statistical analysis.


RESULTS
In all, 376 OA and 141 LA were performed. The two groups were comparable in terms of patient demographics and the incidence of perforated appendicitis. The operative time was also similar (47.3 +/- 19.7 vs 49.9 +/- 12.9 min). The overall incidence of minor or major complications was 11.2% in the OA group and 9.9% in the LA group.


CONCLUSIONS
Pediatric patients with appendicitis can safely be offered laparoscopic appendectomy without incurring a greater risk for complications. Nevertheless, a higher (but not significantly higher) abscess rate was found in patients with perforated appendicitis who underwent laparoscopy.
Oka
T
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Department of Pediatric Surgery, Hasbro Children's Hospital and Brown Medical School, 2 Dudley Street, Providence, RI 02905, USA.
Kurkchubasche
A G
AG
Bussey
J G
JG
Wesselhoeft
C W
CW
Tracy
T F
TF
Luks
F I
FI
D018784:Abdominal Abscess / Q000453:epidemiology / Q000209:etiology; D000293:Adolescent; D000900:Anti-Bacterial Agents; D001062:Appendectomy / Q000379:methods*; D001064:Appendicitis / Q000188:drug therapy / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D005734:Gangrene; D006801:Humans; D007416:Intestinal Perforation / Q000209:etiology; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D011229:Preanesthetic Medication; D011446:Prospective Studies; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000209:etiology; D007507:Therapeutic Irrigation; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents