title: Laparoscopic vs open appendectomy in children: outcomes comparison based on age, sex, and perforation status.
abstract: OBJECTIVE
  Outcomes of laparoscopic appendectomy (LA) will be similar to open appendectomy (OA) in children of all ages.
  
  
  METHODS
  Retrospective cohort study using discharge abstract data.
  
  
  METHODS
  Twelve regional hospitals in Southern California.
  
  
  METHODS
  Seven thousand six hundred fifty patients underwent appendectomy for acute appendicitis (LA = 3551, OA = 4099).
  
  
  METHODS
  Laparoscopic appendectomy or OA.
  
  
  METHODS
  Thirty-day morbidity (wound infection, abscess drainage, and readmission) and length of hospitalization.
  
  
  RESULTS
  Use of laparoscopy increased from 22% in 1998 to 70% in 2007. Overall, patients undergoing LA were older (mean [SD] age, 12.8 [3.2] vs 10.4 [3.7] years; P < .001) and had a lower perforation rate (24% vs 34%; P < .001). Multivariable logistic regression demonstrated a decreased odds ratio for wound infection (odds ratio, 0.6; 95% confidence interval, 0.5-0.8) and abscess drainage (odds ratio, 0.6; 95% confidence interval, 0.4-0.7) following LA compared with OA. Multivariable linear regression also showed decreased length of hospitalization following LA compared with OA.
  
  
  CONCLUSIONS
  Now the preferred operation for children with appendicitis, LA was associated with a decreased risk of wound infection, abscess drainage, and length of hospitalization compared with OA.
authors.affiliation: Harbor-UCLA Medical Center, Torrance, CA 90509, USA. slleemd@yahoo.com
authors.forename: Steven L
authors.initials: SL
authors.lastname: Lee
authors.forename: Arezou
authors.initials: A
authors.lastname: Yaghoubian
authors.forename: Amy
authors.initials: A
authors.lastname: Kaji
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001062:Appendectomy; D001064:Appendicitis / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D012307:Risk Factors; D016896:Treatment Outcome