title: Single-incision laparoscopic-assisted appendectomy in children: exteriorization of the appendix is a key component of a simple and cost-effective surgical technique.
abstract: OBJECTIVE
  Single-incision laparoscopic appendectomy was recently introduced as a less-invasive surgical technique than existing methods, and is increasingly being performed worldwide. We have started to perform transumbilical laparoscopic-assisted appendectomy (TULAA) in children. In this study, we assessed its feasibility, efficacy, and cost-effectiveness compared with conventional multiport laparoscopic appendectomy (MLA).
  
  
  METHODS
  We retrospectively reviewed all of the patients who underwent MLA or TULAA between August 2009 and December 2012. Patient characteristics, operative time, length of hospital stay, postoperative complications, cost-effectiveness, and cosmetic results were analyzed.
  
  
  RESULTS
  A total of 88 patients underwent laparoscopic appendectomy, with MLA in 48 patients and TULAA in 40 patients. TULAA was successful in 36/40 patients. There were no significant differences in mean operative time or mean length of stay between the two groups of patients. There were no postoperative complications in the TULAA group. The cost of TULAA was much lower than that of MLA. TULAA also provided nearly scarless surgery.
  
  
  CONCLUSIONS
  TULAA, in which the appendix is exteriorized via a combination of open and laparoscopic techniques, is a safe and effective procedure for treating appendicitis in children. TULAA is a cost-effective treatment that provides excellent cosmetic results.
authors: Department of Pediatric Surgery, Saitama Children's Medical Center, 2100 Magome, Iwatsuki, Saitama, 339-8551, Japan.
authors: Kyoichi
authors: K
authors: Deie
authors: Hiroo
authors: H
authors: Uchida
authors: Hiroshi
authors: H
authors: Kawashima
authors: Yujiro
authors: Y
authors: Tanaka
authors: Takayuki
authors: T
authors: Masuko
authors: Shinya
authors: S
authors: Takazawa
mesh_terms: D001062:Appendectomy / Q000191:economics / Q000379:methods*; D001065:Appendix / Q000601:surgery*; D002648:Child; D003362:Cost-Benefit Analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000191:economics / Q000379:methods*; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome
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