Laparoscopic and conventional appendicectomy in children: outcomes in English hospitals between 1996 and 2006.
BACKGROUND
Laparoscopic appendicectomy is increasingly used in children. This national retrospective study compared outcomes of paediatric open and laparoscopic appendicectomy.


METHODS
Length of stay, readmission rates and mortality in children undergoing open and laparoscopic appendicectomy in English NHS Trusts between 1 April 1996 and 31 March 2006 were compared. Procedures coded as emergency excision of appendix (OPCS-4 H01) on the Hospital Episode Statistics (HES) database in patients less than 15 years of age were included. Multivariate analysis was used to identify independent predictors of length of hospital stay and mortality.


RESULTS
Eighty-nine thousand, four-hundred and ninety-seven (89,497) appendicectomies were studied; of which, 2,689 (3%) were performed laparoscopically. The percentage of laparoscopic cases rose from 0.6 to 8.4% between 1996 and 2006 (Pearson's r = 0.954, P < 0.001). Length of stay (median 3, interquartile range 2 days, P = 0.068) and 28-day readmission rates were similar (6.3 vs. 7.2%, respectively; P = 0.072) between groups. No independent hospital stay advantage for laparoscopy was observed (P = 0.121). No difference in 30-day mortality (P = 0.986) or 365-day mortality (P = 0.598) was demonstrated.


CONCLUSIONS
Hospital stay, readmission rates and mortality are similar following laparoscopic and open appendicectomy in children.
Faiz
O
O
Department of Biosurgery and Surgical Technology, St Mary's Hospital, Imperial College, Praed Street, London, W21NY, UK. omarfaiz@aol.com
Blackburn
S C
SC
Clark
J
J
Bottle
A
A
Curry
J I
JI
Farrands
P
P
Aylin
P
P
D000293:Adolescent; D001062:Appendectomy / Q000379:methods* / Q000401:mortality; D002648:Child; D002675:Child, Preschool; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D010535:Laparoscopy / Q000379:methods* / Q000401:mortality; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D015999:Multivariate Analysis; D010043:Outcome and Process Assessment, Health Care; D010359:Patient Readmission / Q000706:statistics & numerical data; D012189:Retrospective Studies
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