title: Experiences with LESS-appendectomy in Children.
abstract: OBJECTIVE
  To evaluate the outcome of laparoendoscopic single-site (LESS-A) through one transumbilical port vs. 3-port laparoscopic (3TA) appendectomy in children.
  
  
  METHODS
  We reviewed the records of 309 children (65 LESS-A, 244 3TA) operated on between 2008 and 2012. One hundered forty-nine patients had acute catarrhalis (CA), 133 phlegmonous (PLA), and 27 perforated appendicitis (PA). We compared the duration of operation (DO) the incidence of abdominal abscesses (AA) and wound infections (WI), as well as the degree of appendiceal inflammation (DI) among surgeons with and without board certification.
  
  
  RESULTS
  For all DI, LESS-A resulted in a shorter DO than 3TA (CA 57.9 ± 22.8 vs. 68.5 ± 23.2, P = 0.014; PLA 51.5±16.5 vs. 68.4±33.0, P = 0.006; PA 66.0 ± 29.0 vs. 97.3 ± 41.8, P = 0.039). LESS-A was not used for less complicated cases when compared to 3TA (CA 50.8% vs. 47.5%; PLA 33.8% vs. 45.5%; PA 15.4% vs. 7.0%; CA vs. PLA, P = 0.292; CA vs. PA, P = 0.142; PLA vs. PA, P = 0.031). Surgeons without board certification were assigned to a similar percentage to perform both techniques for any DI (CA 30.3% vs. 37.1%, P = 0.541; PLA 31.8% vs. 40.5%, P= 0.484; PA 40% vs. 35.3%, P = 1.0). We found no significant differences concerning AA (1.5% vs. 1.2%, P = 1.0) and WI (3.1% vs. 1.6%, P = 0.61).
  
  
  CONCLUSIONS
  LESS-A can be done by surgeons with and without board certification for all DI, with shorter DO and similar complication rates as compared to 3TA.
authors.affiliation: Department of Pediatric Surgery and Pediatric Urology, Kliniken der Stadt Koeln gGmbH, Koeln, Germany. rvahdad@aol.com.
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Vahdad
authors.affiliation: Department of Pediatric Surgery, Marien Hospital Herne, Ruhr-University of Bochum, Herne, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Nissen
authors.affiliation: Department of Pediatric Surgery and Pediatric Urology, Kliniken der Stadt Koeln gGmbH, Koeln, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Semaan
authors.affiliation: Department of Pediatric Surgery and Pediatric Urology, Kliniken der Stadt Koeln gGmbH, Koeln, Germany.
authors.forename: Tobias
authors.initials: T
authors.lastname: Klein
authors.affiliation: Department of Surgery, University Hospital Luebeck, Luebeck, Germany.
authors.forename: Emanuel
authors.initials: E
authors.lastname: Palade
authors.affiliation: Department of Pediatric Surgery and Pediatric Urology, Kliniken der Stadt Koeln gGmbH, Koeln, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Boemers
authors.affiliation: Department of Pediatric Surgery, Shiraz University School of Medicine, Laparoscopy Research Center, Shiraz, Iran.
authors.forename: Hamid Reza
authors.initials: HR
authors.lastname: Foroutan
authors.affiliation: Department of Pediatric Surgery, Marien Hospital Herne, Ruhr-University of Bochum, Herne, Germany.
authors.forename: Ralf-Bodo
authors.initials: RB
authors.lastname: Troebs
authors.affiliation: Department of Pediatric Surgery, University Hospital Luebeck, Luebeck, Germany.
authors.forename: Grigore
authors.initials: G
authors.lastname: Cernaianu
mesh_terms: D018784:Abdominal Abscess / Q000453:epidemiology; D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D001062:Appendectomy / Q000379:methods*; D001064:Appendicitis / Q000188:drug therapy / Q000601:surgery*; D002444:Cefuroxime / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D005260:Female; D005858:Germany; D006801:Humans; D007223:Infant; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008795:Metronidazole / Q000008:administration & dosage; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D066231:Surgeons / Q000193:education*; D013530:Surgical Wound Infection / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents; D008795:Metronidazole; D002444:Cefuroxime