title: New primary management for appendiceal masses in children: laparoscopic drainage.
abstract: OBJECTIVE
  The management of appendiceal masses (AM) in children remains controversial. In this study, we evaluated primary laparoscopic drainage (PLD) for efficacy.
  
  
  METHODS
  Eleven (11) consecutive cases of AM (mean age, 8.1 +/- 2.8 years) treated between 2000 and 2004 were the subjects for this study. All had PLD on presentation. If the appendix was seen easily seen after PLD, a laparoscopic appendectomy (LA) was also performed.
  
  
  RESULTS
  Eight (8) patients underwent PLD alone (LD group) and 3 underwent PLD and LA (LDLA group). In the LD group, the mean operating time was 87.9 +/- 23.2 minutes, oral feeding was commenced after a mean of 2.3 +/- 0.8 days, patients became afebrile within 4.3 +/- 3.1 days, intravenous antibiotics were ceased after 5.3 +/- 3.1 days, C-reactive protein normalized within 13.6 +/- 4.2 days, drains were removed within 4.0 +/- 1.3 days, and hospital stay ranged from 7 to 15 days. There were no intra- or postoperative complications related to the PLD procedure. Interval LA was performed 6.8 +/- 5.8 months after PLD in 6 of 8 LD group patients and was not performed in the remaining 2 owing to parental refusal. In the LDLA group, operating time ranged from 125 to 150 minutes, and oral feeding commenced 4, 5, and 5 days after LA, respectively. One (1) patient developed an adhesive bowel obstruction after LA, which resolved with conservative therapy; in the remaining 2, there were no complications. All 11 patients are well after a mean follow-up period of 3.7 +/- 1.0 years. A histologic examination of the excised appendices showed mild to severe inflammation.
  
  
  CONCLUSIONS
  We recommend that PLD be adopted for the primary management of appendiceal masses, as it would appear to be simple, safe, and effective.
authors: Department of Pediatric General & Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan.
authors: Takashi
authors: T
authors: Marusasa
authors: Go
authors: G
authors: Miyano
authors: Yoshifumi
authors: Y
authors: Kato
authors: Toshihiro
authors: T
authors: Yanai
authors: Tadaharu
authors: T
authors: Okazaki
authors: Satoko
authors: S
authors: Ichikawa
authors: Geoffrey J
authors: GJ
authors: Lane
authors: Atsuyuki
authors: A
authors: Yamataka
mesh_terms: D000293:Adolescent; D001062:Appendectomy / Q000379:methods*; D001065:Appendix / Q000473:pathology; D002097:C-Reactive Protein / Q000032:analysis; D002429:Cecal Diseases / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D004322:Drainage / Q000379:methods*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D010397:Penicillanic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives; D000078142:Tazobactam
chemical_list: D010397:Penicillanic Acid; D002097:C-Reactive Protein; D000078142:Tazobactam