title: Laparoscopic versus open appendectomy in the management of acute appendicitis in children: a multicenter retrospective study.
abstract: OBJECTIVE
  Acute appendicitis is one of the most common indications for emergency surgery in children. Open appendectomy (OA) has been the gold standard treatment for over 100 years. In the last three decades, the introduction of minimally invasive techniques, such as laparoscopic appendectomy (LA) and transumbilical laparoscopically assisted appendectomy (TULAA), has changed the approach to the disease. However, there is still no agreement with benefits of these new therapeutic options, especially in children. The aim of this retrospective study is comparing the outcomes of OA, LA and TULAA in the paediatric patient.
  
  
  METHODS
  Children suffering from acute appendicitis were treated with LA or TULAA in the Department of Paediatric Surgery and with OA in the Department of General Surgery. Data were abstracted from database of both centers' archives. Operator, operating time, length of hospitalization (LOH), intra- and postoperative complications and histological finding were analyzed.
  
  
  RESULTS
  We recruited 196 patients: 46 treated with LA, 62 with TULAA and 88 with OA. Operative time was significantly shorter in OA. The three techniques had the same incidence of intraoperative and postoperative complications. The incidence of wound infection was higher with the TULAA approach. LOH was significantly shorter in the TULAA group. There was no correlation between LOH and histological finding.
  
  
  CONCLUSIONS
  We demonstrated that LA, TULAA and OA are similar in most respects and are equally safe modalities in paediatric patients. Further randomized controlled studies are necessary.
authors.affiliation: Pediatric Surgery Unit, Department of Surgery University of Verona, Verona, Italy - luca.giacomello@univr.it>
authors.forename: G
authors.initials: G
authors.lastname: Scirè
authors.forename: A
authors.initials: A
authors.lastname: Mariotto
authors.forename: M
authors.initials: M
authors.lastname: Peretti
authors.forename: E
authors.initials: E
authors.lastname: Buzzi
authors.forename: B
authors.initials: B
authors.lastname: Zani
authors.forename: F
authors.initials: F
authors.lastname: Camoglio
authors.forename: L
authors.initials: L
authors.lastname: Giacomello
mesh_terms: D000293:Adolescent; D001062:Appendectomy / Q000009:adverse effects / Q000379:methods*; D001064:Appendicitis / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007558:Italy; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007813:Laparotomy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay; D008297:Male; D061646:Operative Time; D012189:Retrospective Studies; D012307:Risk Factors; D013529:Surgical Wound Dehiscence / Q000209:etiology; D013530:Surgical Wound Infection / Q000209:etiology; D016896:Treatment Outcome; D014472:Umbilicus