title: Pediatric advanced appendicitis: open versus laparoscopic approach.
abstract: OBJECTIVE
  Optimal surgical approach for advanced pediatric appendicectomy remains controversial. We compare the open versus the laparoscopic approach.
  
  
  METHODS
  Retrospective case notes review of children operated on for advanced appendicitis between January 2005 and July 2006 was undertaken for length of hospital stay, operating time, wound complications, need for further surgery, and hospital readmission.
  
  
  RESULTS
  Forty children were included, 17 were treated with open approach and 23 with laparoscopic approach. There was no conversion from laparoscopic to open approach. Overall complication rate, length of hospital stay, and need for further surgery were similar in both groups. The mean operative time was longer in the laparoscopic group. Wound complications occurred more in the open group. Readmission for gastrointestinal obstruction was noted in the laparoscopic group.
  
  
  CONCLUSIONS
  Laparoscopic approach is safe for advanced appendicitis in children. The outcomes are comparable in both study groups.
authors.affiliation: Paediatric Surgical Unit, Norfolk and Norwich University Hospital, Norwich, UK. ngnwokoma@hotmail.com
authors.forename: Ngozi Joy
authors.initials: NJ
authors.lastname: Nwokoma
authors.forename: Mark G
authors.initials: MG
authors.lastname: Swindells
authors.forename: Karoline
authors.initials: K
authors.lastname: Pahl
authors.forename: Azad B
authors.initials: AB
authors.lastname: Mathur
authors.forename: Ashish
authors.initials: A
authors.lastname: Minocha
authors.forename: Milind
authors.initials: M
authors.lastname: Kulkarni
authors.forename: Thomas
authors.initials: T
authors.lastname: Tsang
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001062:Appendectomy / Q000295:instrumentation / Q000379:methods*; D001064:Appendicitis / Q000601:surgery*; D002648:Child; D002669:Child Welfare; D002675:Child, Preschool; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D011184:Postoperative Period; D012189:Retrospective Studies; D006113:United Kingdom; D055815:Young Adult