Zenon Pogorelic1, Mia Buljubasic2, Tomislav Susnjar3, Miro Jukic3, Tina Poklepovic Pericic4, Ivo Juric5. 1. Department of Pediatric Surgery, University Hospital of Split and University of Split, School of Medicine, Croatia. Correspondence to: Dr Zenon Pogorelic, Department of Pediatric Surgery, University Hospital of Split, Spinciceva 1, 21000 Split, Croatia. zpogorelic@gmail.com. 2. University of Split, School of Medicine, Croatia. 3. Department of Pediatric Surgery, University Hospital of Split, Croatia. 4. Department of Research in Biomedicine and Health, University of Split, School of Medicine; Croatia. 5. Department of Pediatric Surgery, University Hospital of Split and University of Split, School of Medicine, Croatia.
Abstract
OBJECTIVE: To compare the outcomes of treatment in children with acute appendicitis between laparoscopic and open surgical approaches. Design: Retrospective study. SETTING: Division of Pediatric Surgery at a tertiary-care hospital in Croatia between January 2012 to December 2016. PATIENTS: 834 children [median (IQR) age 13 (11,15)] who underwent appendectomy; 301 in the laparoscopic group and 533 in the open group. MAIN OUTCOME MEASURES: Postoperative complications, duration of hospitalization, re-operation, and the quantity of analgesics used. RESULTS: The median length of hospital stay was 3 days in laparoscopic group compared to 6 days in open group (P<0.001). The amount of analgesics used was lower in patients with laparoscopic appendectomy compared to patients who underwent open procedure (P=0.042). Significantly higher number of wound infections was recorded in the open group (n=21; 3.9%) compared to laparoscopic group (n=3; 1%) (P=0.014). The frequency of re-operation in both groups was equal (1.3%). The median duration of surgery was shorter in the group of patients with laparoscopic appendectomy compared to the open approach (30 vs. 45 min; P<0.001). In five-year period, the proportion of laparoscopic appendectomies increased by 21.5%. CONCLUSIONS: Laparoscopic appendectomy was safe and effective in children. Advantages of laparoscopic approach were shorter hospital stay, lower number of wound infections and lower usage of analgesics.
OBJECTIVE: To compare the outcomes of treatment in children with acute appendicitis between laparoscopic and open surgical approaches. Design: Retrospective study. SETTING: Division of Pediatric Surgery at a tertiary-care hospital in Croatia between January 2012 to December 2016. PATIENTS: 834 children [median (IQR) age 13 (11,15)] who underwent appendectomy; 301 in the laparoscopic group and 533 in the open group. MAIN OUTCOME MEASURES: Postoperative complications, duration of hospitalization, re-operation, and the quantity of analgesics used. RESULTS: The median length of hospital stay was 3 days in laparoscopic group compared to 6 days in open group (P<0.001). The amount of analgesics used was lower in patients with laparoscopic appendectomy compared to patients who underwent open procedure (P=0.042). Significantly higher number of wound infections was recorded in the open group (n=21; 3.9%) compared to laparoscopic group (n=3; 1%) (P=0.014). The frequency of re-operation in both groups was equal (1.3%). The median duration of surgery was shorter in the group of patients with laparoscopic appendectomy compared to the open approach (30 vs. 45 min; P<0.001). In five-year period, the proportion of laparoscopic appendectomies increased by 21.5%. CONCLUSIONS: Laparoscopic appendectomy was safe and effective in children. Advantages of laparoscopic approach were shorter hospital stay, lower number of wound infections and lower usage of analgesics.