BACKGROUND: Little is known about 'normal' local sonographic changes occurring in the postoperative period after an uneventful appendectomy. OBJECTIVE: To analyse the local changes on US examination occurring after uneventful open (OA) or laparoscopic (LA) appendectomy in children with normal histology and with nonperforated acute appendicitis. MATERIALS AND METHODS: US was prospectively performed in 82 children (54 boys and 28 girls) aged 1-16 years (mean 11.6+/-3.2 years), 3 days following LA (n=51, 62%) or OA (n=31, 38%) for nonperforated appendicitis. Multivariate analysis was performed using stepwise logistic regression, with the following starting variables: surgical technique, gender, pathological finding, appendix location, and histology. RESULTS: Of the 82 patients, 35 (42.7%) had postoperative pathological US findings such as peritoneal fluid, oedematous mesenteric fat and thickening of the bowel wall. While the overall incidence of pathological US findings between OA and LA groups was not significantly different, multivariate logistic regression analysis showed that OA is associated with a reduction by a factor of 0.35 in the odds ratio of postoperative pathological US findings (P=0.007). CONCLUSION: Pathological US findings are common in children after appendectomy, particularly after LA. Awareness of these pathological findings might prevent unnecessary postoperative treatment.
BACKGROUND: Little is known about 'normal' local sonographic changes occurring in the postoperative period after an uneventful appendectomy. OBJECTIVE: To analyse the local changes on US examination occurring after uneventful open (OA) or laparoscopic (LA) appendectomy in children with normal histology and with nonperforated acute appendicitis. MATERIALS AND METHODS: US was prospectively performed in 82 children (54 boys and 28 girls) aged 1-16 years (mean 11.6+/-3.2 years), 3 days following LA (n=51, 62%) or OA (n=31, 38%) for nonperforated appendicitis. Multivariate analysis was performed using stepwise logistic regression, with the following starting variables: surgical technique, gender, pathological finding, appendix location, and histology. RESULTS: Of the 82 patients, 35 (42.7%) had postoperative pathological US findings such as peritoneal fluid, oedematous mesenteric fat and thickening of the bowel wall. While the overall incidence of pathological US findings between OA and LA groups was not significantly different, multivariate logistic regression analysis showed that OA is associated with a reduction by a factor of 0.35 in the odds ratio of postoperative pathological US findings (P=0.007). CONCLUSION: Pathological US findings are common in children after appendectomy, particularly after LA. Awareness of these pathological findings might prevent unnecessary postoperative treatment.
Authors: Marcos T A Rosário; Ulysses Ribeiro; Carlos E P Corbett; Alberto C Ozaki; Cláudio C Bresciani; Bruno Zilberstein; Joaquim J Gama-Rodrigues Journal: J Surg Res Date: 2005-12-19 Impact factor: 2.192