Prospective evaluation of a primary laparoscopic approach for children presenting with simple or complicated appendicitis.
BACKGROUND
Previous studies have suggested laparoscopy leads to an increased risk of postoperative intra-abdominal abscess formation in complicated appendicitis. The purpose of this study is to prospectively evaluate a standardized laparoscopic approach applied by a single surgeon for all children who present with appendicitis and to determine the postoperative outcome.


METHODS
Over a 5-year period (2001-2005), all children presenting to the author with simple or complicated appendicitis were approached laparoscopically and their preoperative workup, intraoperative findings, and postoperative outcomes recorded.


RESULTS
One hundred seventy-five consecutive laparoscopic appendectomies were performed with no open conversions. Mean patient age was 9 years. Sixty-seven patients (38%) presented with complicated appendicitis. The overall complication rate was 6% (9 children developed a postoperative intra-abdominal abscess or phlegmon and 2 had umbilical wound infections).


CONCLUSIONS
When laparoscopic appendectomy is used as the primary technique, only 6% of patients experience infectious complications. Therefore, a laparoscopic approach to all children presenting with appendicitis does not lead to an increased complication rate.
Partrick
David A
DA
Department of Pediatric Surgery, The Children's Hospital, University of Colorado Health Sciences Center at Denver, 1056 East 19th Avenue, B-323, Denver, CO 80218, USA. Partrick.David@tchden.org <Partrick.David@tchden.org>
D015746:Abdominal Pain / Q000209:etiology; D000293:Adolescent; D001062:Appendectomy / Q000379:methods*; D001064:Appendicitis / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D010535:Laparoscopy; D008297:Male; D011446:Prospective Studies; D016896:Treatment Outcome