title: Conventional single-port laparoscopic appendectomy for complicated appendicitis in children: Efficient and cost-effective.
abstract: BACKGROUND
  Laparoscopic appendectomy (LA) is gradually gaining popularity among paediatric surgeons for complicated appendicitis. A retrospective study was conducted to compare conventional single port LA, multiport LA and open appendectomy (OA) for complicated appendicitis in children.
  
  
  METHODS
  From January 1995 from December 2014, 1,408 patients (604 girls, 804 boys) underwent surgery for uncomplicated and complicated appendicitis. The patient characteristics, operation times, duration of hospitalization, operative costs, and postoperative complications were recorded. A 10-mm 0(°) scope with a parallel eye piece and an integrated 6 mm working channel were inserted through an 11-mm "conventional umbilical port" for single port LA.
  
  
  RESULTS
  A total of 314 patients with complicated appendicitis (128 girls, 186 boys) underwent appendectomy. Among these, 102 patients (32.4%) underwent single port LA, 17 patients (5.4%) underwent multiport LA and 195 patients (62.1%) underwent OA. The hospital stay of the single port LA group was significantly less (3.88 ± 1.1) compared with multiport LA (5.41 ± 1.2) and OA groups (6.14 ± 1.1) (P < 0.001). Drain usage, wound infection and adhesive intestinal obstruction rates were significantly high in the OA group. There was no significant difference between the groups in postoperative intraabdominal abscess formation. Single-port LA performed for complicated appendicitis was cheaper compared with the other groups.
  
  
  CONCLUSIONS
  The present study has shown that single-port LA for complicated appendicitis can be conducted in a reasonable operative time; it shortens the hospitalization period, markedly reduces postoperative wound infection and adhesive intestinal obstruction rates and does not increase the operative cost.
authors.affiliation: Department of Pediatric Surgery, Medical School, Dokuz Eylül University, Izmir, Turkey.
authors.forename: Osman Zeki
authors.initials: OZ
authors.lastname: Karakuş
authors.affiliation: Department of Pediatric Surgery, Medical School, Dokuz Eylül University, Izmir, Turkey.
authors.forename: Oktay
authors.initials: O
authors.lastname: Ulusoy
authors.affiliation: Department of Pediatric Surgery, Medical School, Dokuz Eylül University, Izmir, Turkey.
authors.forename: Oğuz
authors.initials: O
authors.lastname: Ateş
authors.affiliation: Department of Pediatric Surgery, Medical School, Dokuz Eylül University, Izmir, Turkey.
authors.forename: Gülce
authors.initials: G
authors.lastname: Hakgüder
authors.affiliation: Department of Pediatric Surgery, Medical School, Dokuz Eylül University, Izmir, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Olguner
authors.affiliation: Department of Pediatric Surgery, Medical School, Dokuz Eylül University, Izmir, Turkey.
authors.forename: Feza Miraç
authors.initials: FM
authors.lastname: Akgür
keywords: Appendicitis; children; complicated appendicitis; laparoscopic appendectomy (LA); single-port surgery