title: Acceptable outcome after laparoscopic appendectomy in children.
abstract: BACKGROUND
  An increasing proportion of childhood -appendicitis is being treated with laparoscopic appendectomy (LA). We wanted to elucidate the outcome of childhood appendicitis treated primarily by residents in a university hospital.
  
  
  METHODS
  All children (age<16 years) with appendectomy treated surgically in our department between January 2006 and January 2011 were identified retrospectively. Readmission, reoperation or post-operative length of hospital stay (LOS) exceeding five days were considered non-satisfactory outcomes.
  
  
  RESULTS
  A total of 390 children had an appendectomy performed. The mean age was 9.8 years, and mortality was 0.0%. The surgeon was a resident in 92% of the cases. A total of 246 (63.1%) had an LA. The rate of LA increased over the five-year period from 45% to 88% (p=0.01). The conversion rate decreased from 28% to 15% (p=0.02). The median post-operative LOS was one and three days for simple and complicated appendicitis, respectively. A total of 45 patients (11.5%) had a complication, 40 patients (10.3%) were readmitted, and 56 patients (14.4%) had a non-satisfactory outcome. Logistic regression found open surgery and complicated appendicitis to be associated with an increased risk of complications (p<0.01).
  
  
  CONCLUSIONS
  Increased use of LA did not increase the number of patients with a non-satisfactory outcome. Residents manage this treatment at a highly professional level. Readmission due to pain and discomfort was frequent and more targeted and systematic post-operative analgesic care of our children is called for.
  
  
  BACKGROUND
  Not relevant.
  
  
  BACKGROUND
  The study was submitted to ClinicalTrials.gov (NCT01657565).
authors: Department of Surgery, Odense University Hospital, 5000 Odense, Denmark. nicolajstilling@gmail.com
authors: Nicolaj M
authors: NM
authors: Stilling
authors: Claus
authors: C
authors: Fristrup
authors: Torben
authors: T
authors: Gabers
authors: Niels
authors: N
authors: Qvist
authors: Lars
authors: L
authors: Rasmussen
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001062:Appendectomy / Q000009:adverse effects / Q000639:trends; D001064:Appendicitis / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D002983:Clinical Competence; D005260:Female; D006801:Humans; D007223:Infant; D007396:Internship and Residency; D010535:Laparoscopy / Q000009:adverse effects / Q000639:trends; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D010359:Patient Readmission / Q000706:statistics & numerical data; D012189:Retrospective Studies; D016896:Treatment Outcome