title: Transumbilical laparo-assisted appendectomy: a safe operation for the whole spectrum of appendicitis in children-a single-centre experience.
abstract: The paper reports the results of a retrospective review of the medical charts of 203 patients admitted to a pediatric surgical unit with a diagnosis of acute appendicitis between January 2006 and December 2010 when a transumbilical laparoscopic-assisted appendectomy (TULAA) was introduced as a new surgical technique. Among 203 admitted patients, 7 (3.5%) had a localized appendiceal abscess and were treated with antibiotics. All of them responded to antibiotics and underwent TULAA interval appendectomy 8 weeks later. 196 patients (96.5%) underwent immediate surgery. In 12/181 (6.6%) urgent cases, conversion to laparotomy was necessary, in 3 patients because of bowel distension and in 9 for retrocecal position of appendix. In all 181 TULAA completed procedures, one trocar was used in 151 cases (89.4%), two trocars in 16 (9.4%), and three trocars in 2 (1.2%). The mean operative time for single port TULAA was 52' Complications included 5 wound infections and 5 intra-abdominal abscesses, all managed conservatively. In conclusion, TULAA is a safe, minimally invasive approach with acute appendicitis, regardless of the perforation status, and can be recommended in the pediatric urgical settings.
authors.affiliation: Unit of Pediatric Surgery and Urology, Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy ; Department of Pediatric Surgery, Children's Hospital Burlo Garofolo, Via dell'Istria 65/1, 34100 Trieste, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Codrich
authors.forename: M G
authors.initials: MG
authors.lastname: Scarpa
authors.forename: M A
authors.initials: MA
authors.lastname: Lembo
authors.forename: F
authors.initials: F
authors.lastname: Pederiva
authors.forename: D
authors.initials: D
authors.lastname: Olenik
authors.forename: F
authors.initials: F
authors.lastname: Gobbo
authors.forename: A
authors.initials: A
authors.lastname: Giannotta
authors.forename: S
authors.initials: S
authors.lastname: Cherti
authors.forename: J
authors.initials: J
authors.lastname: Schleef