title: Laparoscopic versus open appendicectomy in children: a UK District General Hospital experience.
abstract: OBJECTIVE
  The aim of this study was to evaluate the potential role of laparoscopic appendicectomy in reducing morbidity and length of stay in children compared to open procedures in a UK District General Hospital setting.
  
  
  METHODS
  A three-year retrospective review of children ≤ 15 years with histologically confirmed appendicitis who underwent laparoscopic (LA) and/or open (OA) appendicectomy was performed. Choice of operation was based on individual surgeon's preference and on patient's body size. Data collected included rate of histologically complicated appendicitis, post-operative length of stay (LOS), and collective and differential morbidity rates, i.e., wound infection, intra-abdominal collection, and ileus. Chi-square and Mann-Whitney tests were used for statistical analysis. P<0.05 was regarded as significant.
  
  
  RESULTS
  Eighty children (70% male) were identified at median age 11 (3-15) years. They could be divided into complicated (n=18, 22%) and simple appendicitis (n=62, 78%). Appendicectomy was performed in all as an OPEN (n=53, 66%) or LAPAROSCOPIC (n=27, 34%) procedure. Both groups were comparable in gender distribution (P=0.11) and rate of complicated appendicitis (30% vs. 19%, respectively; P=0.27). Median age was significantly lower in the OPEN group [10 (3-15) vs. 12 (7-15) years; P<0.004]. Laparoscopic appendicectomy had a significantly lower rate of collective morbidity (3.8% vs. 25.9%; P<0.003), including lower rate of intra-abdominal collection (1.9% vs. 14.8%; P<0.01). Median LOS was not significantly different (1 day vs. 2 days; P=0.14).
  
  
  CONCLUSIONS
  Laparoscopic appendicectomy in children in a UK District General Hospital is safe and was associated with significantly less post-operative morbidity than the open technique.
authors: West Suffolk Hospital NHS Foundation Trust, Bury St Edmunds, Suffolk, UK. Electronic address: h.adwan@ucl.ac.uk.
authors: Hussamuddin
authors: H
authors: Adwan
authors: West Suffolk Hospital NHS Foundation Trust, Bury St Edmunds, Suffolk, UK.
authors: Chathika K
authors: CK
authors: Weerasuriya
authors: West Suffolk Hospital NHS Foundation Trust, Bury St Edmunds, Suffolk, UK.
authors: Phillip
authors: P
authors: Endleman
authors: West Suffolk Hospital NHS Foundation Trust, Bury St Edmunds, Suffolk, UK.
authors: Alice
authors: A
authors: Barnes
authors: West Suffolk Hospital NHS Foundation Trust, Bury St Edmunds, Suffolk, UK.
authors: Lara
authors: L
authors: Stewart
authors: West Suffolk Hospital NHS Foundation Trust, Bury St Edmunds, Suffolk, UK. Electronic address: Tim.Justin@wsh.nhs.uk.
authors: Timothy
authors: T
authors: Justin
mesh_terms: D000293:Adolescent; D001062:Appendectomy / Q000379:methods*; D001064:Appendicitis / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome; D006113:United Kingdom
keywords: District general hospital; Laparoscopic appendicectomy; Open appendicectomy