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Objective:To analyze and summarize the imaging characteristics and clinical follow-up results of Ewing sarcoma of bone.Methods:The imaging data of 23 patients with Ewing sarcoma confirmed by pathology who treatment in Drum Tower Hospital Affiliated to Nanjing University School of Medicine from May 2010 to October 2021 were retrospectively analyzed, and clinical follow-up was performed.Results:Of the 23 patients with Ewing sarcoma of the bone in this group, a total of 18 patients had follow-up results and 5 cases were lost to follow-up. Of the 18 cases, 6 cases died and 12 cases survived. The main cause of death was lung metastasis. There were 27 lesions in total, femoral diaphysis was the most common site of the disease; bone structure destruction and soft tissue mass shadows could be seen in the images of each lesion. Periosteal reaction could be seen in most of the lesions (92.59%, 25/27). There were certain differences in signs of bone destruction and periosteal reaction between different bone types.Conclusions:The imaging of Ewing sarcoma of bone mainly manifests various types of bone destruction, soft tissue masses and periosteal reactions. Ewing sarcoma of bone is mainly bone marrow metastasis and lung metastasis, and lung metastasis is the main cause of death.
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Objective:To investigate the differences of psychological condition of erectile dysfunction (ED) patients in different age groups.Methods:The emotion, personality and interpersonal relationship outpatients with ED were evaluated by the method of Symptom Checklist-90 (SCL-90), State Trait Anxiety Inventory (STAI) and Eysenck Personality Questionnaire (EPQ). A retrospective analysis was conducted and a total of 401 ED patients (aged 20-60) were divided into 4 groups [20-29(n=158), 30-39(n=182), 40-49(n=38), 50-60 (n=23)years old] from July 2018 to July 2019. The erectile function of the patients was evaluated by the international erectile function scale (IIEF-5). The symptoms of hostility, anxiety, psychotic, horrible, paranoid, obsession, somatization, interpersonal relationship and depression were evaluated by SCL-90. Furthermore, STAI was used to distinguish whether the patients had state or trait anxiety. Then EPQ was used to analyze the personality types of patients. The differences of SCL-90, STAI and EPQ between the patients and the national norm group were analyzed by the two sample t-test. The variance analysis was conducted to compare the score differences of scales among different age groups of ED patients. The chi square test was conducted to compare the distribution differences of personality types among different age groups. Results:The scores of hostility(1.64±0.67, t=4.81, P<0.001), anxiety(1.58±0.66, t=6.83, P<0.001), psychotic(1.62±0.68, t=11.87, P<0.001), paranoid(1.55±0.66, t=3.58, P=0.0004), obsession(1.95±0.70, t=9.56, P<0.001), somatization(1.43±0.58, t=2.10, P=0.036), interpersonal relationship(1.74±0.74, t=2.79, P=0.005), depression (1.66±0.74, t=4.50, P<0.001)and the total scores (1.53±0.63, t=3.07, P=0.002)of SCL-90 in the patient group were significantly higher than those of the national norm group, and there were significant differences in the scores of interpersonal relationship among different age groups(1.72±0.78, 1.65±0.69, 1.58±0.92, 1.43±0.59, F=2.84, P=0.038). The scores of state anxiety( t=7.35, P<0.001), trait anxiety ( t=6.31, P<0.001)and the total scores ( t=8.41, P<0.001)of STAI in the patient group were significantly higher than those of the national norm, and there were significant differences in the scores of state anxiety( F=5.29, P=0.001), trait anxiety ( F=5.54, P<0.001)and total scores ( F=5.66, P<0.001)among different age groups. There were significant increases in the scores of psychoticism( t=30.56, P<0.001), emotion( t=45.94, P<0.001), extraversion and introversion( t=11.72, P<0.001), concealment factors ( t=29.16, P<0.001)and total scores ( t=30.56, P<0.001)in the patient group. The proportion of depressive personality was highest in the ED patients(n=183; 45.64%), but there was no significant difference in the distribution of personality types among different age groups[20-29(depressive, choleric, mucinous and sanguine): 76, 35, 26, 21; 30-39: 87, 40, 32, 23; 40-49: 14, 10, 6, 8; 50-60: 6, 9, 2, 6; χ 2=10.65, P=0.30]. Conclusions:ED patients have a series of abnormal emotions, somatized discomfort, sensitive interpersonal relationships, introverted and unstable emotionally personality characteristics. In addition, the younger the patients are, the more serious their anxiety are, the more sensitive their interpersonal relationships are, which may be related to their introverted personality characteristics and emotional instability.
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Objective To explore the feasibility and repeatability of deltoid muscle volume measurement using MR volume of interest method, and discuss the clinical significance. Methods Seventy-eight subjects'' MR images were retrospectively reviewed including 33 normal shoulders, 22 rotator cuff tear (7 male, 15 female), 12 cases with labrum lesions (11 male, 1 female), and 2 long head of biceps tendon lesions. Routine axial 2D MR images of deltoid muscle were transported into post-processing work station, the matrix of all images were higher than 275 × 336, and the imaging field included the upper and lower margin of the deltoid muscle, and the three dimension shape of muscle was reconstructed by software based on MR volume of interest, then the muscle volume was calculated automatically. This process was independently performed by 2 operators, and operator 1 repeated this process 1 week later. Intra-class correlation coefficient and 95％confidence interval were used to analyze the reliability and repeatability of the measurement. Deltoid muscle volumes of different ages and different pathological processes were compared using stratified sampling method, one-way analysis of variance (ANOVA), least significant difference (LSD) multiple comparison method, and independent-samples t test. Results Three-dimensional shape of deltoid muscle were well demonstrated and corresponded well to the known anatomy. The measurement showed very good inter-and intra-observer consistency (ICC: 0.983 and 0.995, respectively). There were statistical differences in deltoid muscle volume between group A and C [volume:(382.39 ± 38.87) cm3 and (279.15 ± 63.65) cm3;P=0.000], group B and C [volume:(358.49 ± 44.50) cm3 and (279.15 ± 63.65) cm3; P=0.000]. The normal participants were divided by gender into normal group 1 (9 males and 15 females) and normal group 2 (13 males and 1 female) using stratified random sampling method. The deltoid muscle volume of patients with rotator cuff tear was lower than the normal group 1 [volume:(313.21±63.48) cm3 versus (359.08±57.98) cm3;t=-2.562, P<0.05], and there was no statistical difference in deltoid muscle volume between labrum-ligament complex lesions patients and the normal group 2 [volume: (394.28 ± 33.67) cm3 versus (389.30 ± 22.14) cm3; t=0.385, P=0.704]. Conclusions Volume of interest measurement based on routine MR images could evaluate the deltoid muscle volume conveniently and directly, and which could be used as a preferred choice for muscle volume evaluation.
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Objective To explore the therapeutic effects and mechanisms of umbilical cord mesenchymal stem cells(UC-MSCs)implantation on knee osteoarthritis(OA)in rabbits. Methods The healthy adult New Zealand rabbits were divided into control group(n=4),OA model group(n=4),and treatment group(n= 4).OA model was induced by 4% papain injection(0.1 ml/kg for 2 times),and treatment group were treated with UC-MSCs implantation(1 ml,1×105/L).At 2 weeks after papain injection for preparation of osteoarthritis model,rabbits knee joints were examined by MRI,and synchrony serum levels of IL-6 and-8,MMP-3 and-13 were tested.At 3 weeks after papain injection for OA,1×106/L 1 ml UC-MSCs were injected into articular cavity in treatment group,and normal saline was injected into articular cavity in blank control group and OA model group.At 2 weeks and 4 weeks after the treatment,serum levels of IL-6 and IL-8,MMP-3 and MMP-13 were tested respectively.At 4 weeks after the treatment,knee joints were reexamined again by MRI.After this,the rabbits were sacrificed and synovium and articular cartilage were taken out for HE and immunohistochemistry examination.Serum levels of IL-6 and IL-8,MMP-3 and MMP-13 were tested by ELISA method. Results The levels of inflammatory cytokines such as IL-6,IL-8,MMP-3,MMP-13 were significantly higher in model group 〔(44.7 ± 14.5)μg/L,(7.6 ± 2.5)μg/L,(16.5 ± 4.3)μg/L,(4.50 ± 1.20)μg/L〕and in treatment group 〔(43.9 ± 15.2)μg/L,(9.8 ± 2.9μg/L),(18.3 ± 4.9) μg/L,(4.80 ± 1.80)μg/L〕than in control group〔(20.8 ± 11.2)μg/L,(1.2 ± 0.6)μg/L,(2.8 ± 0.9) μg/L,(0.02 ± 0.02)μg/L〕(all P < 0.05).The levels of IL-6,IL-8,MMP-3,MMP-13 were significantly lower after UC-MSCs treatment〔(23.8 ± 11.4)μg/L,(2.4 ± 1.3)μg/L,(10.5 ± 3.4)μg/L,(0.50 ± 0.20)μg/L〕than before treatment(all P<0.05).Based on magnetic resonance imaging,the treatment group versus model group showed an improved coarse cartilage surface,thickened subchondral bone and synovium,and decreased volume of joints effusion.Pathological finding showed lower levels of inflammatory reaction in cartilage and synovium in the treatment group versus model group.Immunohistochemistry showed lower levels of IL-6 and MMP-13(all P<0.05). Conclusions The inflammatory response of cartilage and synovial tissue induces OA progress,and the inflammation factors play a significant role in OA progress.UC-MSCs could protect cartilage and synovial membrane of joints and inhibit the inflammatory response.Therefore,this study provides new therapy method for OA.
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Objective To evaluate the feasibility of anticoagulant therapy for acute proximal deep vein thrombosis without inferior vena cava filter placement for femoral neck patients before hip arthroplasty.Methods From January 2013 to August 2017,9 femoral neck fractures patients with acute proximal deep vein thrombosis before hip arthroplasty were enrolled into this study.There were 3 men and 6 women.The average age was 76.44±5.39 years old (range,69 to 83 years old).The average injured time before admission was 4.00±4.06 days.All patients received anticoagulant therapy without placement of inferior vena cava filter before hip arthroplasty.Four patients received Rivaroxaban 10mg,two times per day,while two patients received Enoxaparin 0.4 ml,two times per day;3 cases received Batroxobin 0.5 ml,every other day combined with Rivaroxaban 10 mg one time per day or Enoxaparin 0.4 ml,one time per day.The size of thrombus before and after treatment,changes of coagulation markers,the outcome of thrombosis before surgery,during surgery,postoperatively and during follow-up,the related complications were recorded.Results The diagnosis time for proximal DVT was 3.89±3.01 days after admission.8 patients showed proximal DVT combined with distal thrombus and 1 patient showed isolated proximal DVT.The average length of proximal thrombus was 10.78±6.10 cm (range,4.0-20.0 cm).The mean duration of treatment was 14.22±7.03 days.The results showed 5 proximal DVTs have complete disappeared,3 cases significantly improved,and 1 case had no change but showed stable.After treatment,the length of the proximal thrombus was significantly decreased (10.77±6.10 cm vs.4.39±6.50 cm),there were statistically significant between two groups (t=3.429,P=0.009);D-dimer was significantly lower after treatment (10.47±4.87 μg/ml vs.2.59± 1.60 μg/ml) with statistical difference (t=4.970,P=O.O01).However,no statistical significance was found in other coagulation parameters such as plasma prothrombin time,the international normalized ratio,activated partial thromboplastin time,thrombin time,fibrinogen.Incision exudate occurred in one patient and anticoagulant therapy was paused,however,two days later,DVT recurred and then the patient received continuous therapy with drug anticoagulation.The average time for postoperative follow-up was 8.3±7.6 months.At the latest follow-up,4 cases had thoroughly recovered with the thrombi fully resolved;4 cases had significantly improved including three thrombi partly locating in the muscular veins and one partly locating in the infra-popliteal vein.One case became more severe after discharge and received continuous anticoagulant therapy.No death,symptomatic pulmonary embolism,bleeding and other adverse events occurred.Conclusion Inferior vena cava filter placement for femoral neck fracture patients with acute proximal venous thrombosis before hip arthroplasty may not be potent.Anticoagulant therapy which make the proximal thrombus completely dissolved or stabilized before surgery may be effective.
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Objective To explore clinical characteristics of patients with Klinefelter′s syndrome(KS; 47,XXY).Methods 227 male patients with 47,XXY treated by artificial insemination with donor(AID)were included.Age, education, height, weight, body mass index(BMI), testicular volume, FSH, LH, testosterone(T), prolactin(PRL), estradiol(E2)were analyzed retrospectively.Results Of these patients, their height were(176.4±5.5)cm, weight(74.5±12.7)kg, BMI(23.89±3.66)kg/m2[77 of overweight(33.92%)and 34 of obesity(14.98%)], FSH(38.35±14.33)IU/L, LH(19.40±9.00)IU/L, T(132.00±194.50)ng/dl, E2(23.90±15.00)ng/L, PRL(10.50±8.20)μg/L, E2/T 0.21±0.80.Testicular volume had the positive association with the level of T(r=0.197, P=0.003).BMI had the negative association with the serum concentration of T(r=-0.284, P=0.000), while positive association with the E2(r=0.174, P=0.009)and ratio of E2/T(r=0.323, P=0.000).Age had no association with T, E2, and E2/T(P>0.05), but had negative association with the serum concentration of LH(r=-0.154, P=0.02)nd FSH(r=-0.196,P=0.03).The higher education group were older(P<0.01), while the level of T were lower(P<0.01).Conclusion In patients with Klinefelter′s syndrome(KS; 47,XXY), level of T may associate with testicular volume.T, E2, and the ratio of E2/T seem to associate with their height, BMI, and education level.
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Objective To analyze the characteristics of proximal deep vein thrombosis (DVT) after total joint arthroplasty.Methods 40 cases of proximal DVT were collected from May 2007 to October 2016 which were all diagnosed by lower limb venography or sonography.There were 9 males and 31 females aged from 38 to 86 years,average 67 years,and body mass index was from 16.94 to 31.25kg/m2,with an average of 24.3 kg/m2.29 cases of THA patients and 11 cases of TKA patients.The anatomical distribution,size,radiological performance,local physical findings were recorded and multivariable analysis was performed to evaluate the relationship between distribution of proximal DVT and related parameters including age,gender (male/female),side of leg(left/right),surgery type(knee and hip),preoperative diagnosis(femoral neck fracture/other disease),time of diagnosis with DVT (during hospitalization/after discharge).Results Among 40 proximal DVT cases,31 cases diagnosed by phlebography and 9 cases were diagnosed by ultrasound.2 cases were isolated proximal DVT while 38 cases connected with distal DVTs.9 cases of blood clots in the proximal and distal thrombosis connected discontinuously.There was no isolated proximal DVT in TKA group and 10 cases (90.9％) of blood clots in the proximal and distal thrombosis connected continuously while there were 2 cases (6.9％) isolated proximal DVTs in THA group and 21 (77.8％) of blood clots in the proximal and distal thrombosis connected discontinuously,and there was no statistic significant difference between the two groups.The average length of proximal was 8.85±9.3 1cm (range from 2-35cm) with 5.0±2.05 cm in TKA group and 10.31 ± 10.55 cmin THA group.A significant difference was found between the 2 groups (P=0.014).13 cases located in femoral veins and upper venous region which were all from THA group.There was a significant difference in the distribution between surgery type and preoperative diagnosis.However,there was no significant difference between other potential factors and distribution of proximal DVT.25 cases accepted the evaluation of symptom of DVT before scanning.However,no significant difference were found in edema,VAS score,Homans sign,Neuof sign between 9 TKA and 16 THA cases.Conclusion Proximal DVTs after knee and hip arthroplasty are more preferred to connect with distal DVT continuously.Surgery type and preoperative diagnosis have a significant effect on the distribution of proximal DVT.Proximal DVTs in THA and patients with preoperative femoral neck fracture could be more easily involving femoral veins and upper parts.
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Objective To evaluate the feasibility of low-tube-voltage, low injection rate, low contrast agent dosage in combination with iterative model reconstruction ( IMR) algorithm in CT angiography ( CTA) of the head-and-neck vessels .Methods Sixty patients who underwent CT angiography of the head-and-neck vessels were randomly divided into groups A and B with 30 cases in each group .Patients in group A received a conventional scan with 120 kVp and filterback projected ( FBP) reconstruction .Patients in group B received a low-dose scan with 80 kVp, and image reconstruction with FBP ( group B1) and IMR (group B2)algorithm.The contrast agent protocol were as follows: the injection time in all patients was 10s, the injection rate was 4.5-5.5 ml/s in group A while 3.5-4.0 ml/s in group B.The CT values of artery, image noise, signal to noise ratio ( SNR) and contrast to noise ratio ( CNR) were measured and compared among three groups with One-way ANOVA analysis . Image quality was evaluated by two radiologists with five scale method , and compared with Kruskal-Wallis test .The CT dose index volume (CTDIvol) and dose length product ( DLP) were recorded and compared between groups with two independent samples t-test.Results The image quality scores of groups A , B1and B2 were 3-5, 2-4 and 3 -5, respectively .Image quality of twelve patients in group B 1 couldn′t meet the diagnostic requirements but none in group A and B 2.The objective image parameters SNR and CNR for group B 2 were equal to group A ( P >0.05), while those for group B1 were lower than group A (t=13.39, 9.45, P<0.05) and group B2 (t=-12.14, -9.96,P<0.05).CTDIvol and DLP for group B were separately 80.9%, 81.3%lower than those of group A(t=39.1, 32.2,P<0.05).The injection rate and contrast agent volume for group B were separately 22.0%, 22.1% lower than those of group A ( t=20.8, 20.8, P<0.01) .Conclusions It is feasible in CT angiography of the head-and-neck vessels with lower tube-voltage, lower injection rate, lower contrast agent dose and combining with iterative model reconstruction algorithm.This protocol can reduce the radiation dose by 81.3% while maintaining image quality .Trial registration Chinese clinical trial registry ,ChiCTR-BOC-16010060.
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Objective To evaluate the diagnostic value of ultrasonography and MRI in the diagnosis of placenta accrete.Methods First,the relevant literatures about placenta accrete were retrieved at home and abroad,then the data were extracted and Meta-analysis was performed.The combined sensitivity and specificity of ultrasound and MRI and AUC were obtained.Results The combined sensitivity of ultrasonography was 0.80,specificity was 0.88,AUC was 0.88;combined sensitivity of MRI was 0.86,specificity was 0.90,AUC was 0.93.Conclusion Ultrasound and MRI are very valuable in the diagnosis of placenta accrete.However,MRI is a useful complement of ultrasound,and the diagnostic value is slightly better than that of ultrasound.The diagnostic value will be higher when they combined together.
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Objective To investigate the feasibility of setting mAs in liver enhanced CT scan according to plain scan noise with fixed mA CT scanner,in order to reduce the radiation dose.Methods One hundred continuous patients underwent liver enhanced CT scan (group A) prospectively.Two hundred and fifty mAs was used in plain and enhanced CT scans.Noises of plain and venous phase CT images were measured,and the image quality was evaluated.The equation between mAs of enhanced scan and noise of plain scan image was derived.Another 100 continuous patients underwent liver enhanced CT scan (group B).Enhanced scan mAs was calculated from noise on plain scan by using the equation above.Noises on venous phase images were measured and the image quality was measured.Based on body mass index (BMI),patients in groups A and B were divided into three subgroups respectively:BMI ＜ 18.5 kg/m2,18.5 kg/m2 ≤ BMI ＜ 25.0 kg/m2 and BMI ≥ 25.0 kg/m2.Image quality score was compared with nonparametric rank sum test,CT dose index (CTDI) and effective dose (ED) were measured and compared between each subgroup with 2 independent samples t or t' test.Results The equation between enhanced scan mAs (mAsX) and plain scan noise (SDp) was as follows:mAsX =mAs1 × [(0.989 × SDp + 1.06) /SDx]2,mAs1 =250 mAs,SDx =13.In patients with BMI ＜ 18.5 kg/m2,ED of group A [(6.86 ±0.38) mSv,n =12] was significantly higher than group B [(2.66 ±0.46) mSv,n =10)] (t =18.52,P ＜0.01).In patients with 18.5 kg/m2 ≤ BMI ＜ 25.0 kg/m2,ED of group A [(7.08 ± 0.91) mSy,n =66] was significantly higher than group B [(4.50 ± 1.41) mSv,n =73] (t' =10.57,P ＜ 0.01).In patients with BMI ≥25.0 kg/m2,there was no significant difference between EDs of group A (7.54 ± 0.62 mSv,n =22) and group B [(8.19 ±3.16) mSv,n =17] (t' =0.89,P =0.39).Image quality of 5 patients in group A and none in group B did not meet the diagnostic requirement.Conclusion Setting mAs of enhanced scan according to plain scan noise could reduce the radiation dose with maintainence of image quality.
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ObjectiveTo investigate the role of magnetic resonance imaging (MRI) in treatment efficacy evaluation of polymyositis and dermatomyositis.MethodsFifteen patients with polymyositis and dermatomyositis underwent MRI of thigh were included.Scores of MRI signal intensity of the diseased muscle of every patient were compared before and after treatment and the correlation between serum creatinkinase (CK) level and muscle strength grade were also compared.Correlations between muscle strength grade and MRI score,as well as muscle strength grade and creatinkinase level were analyzed.Comparisons between groups were tested by t test,and the relationship between muscle strength and clinical data was analyzed by Pearson's correlation analysis.ResultsThe signal score of MRI was counted before and after therapy(2.37±0.62,1.30±0.28,respectively,P＜0.05),and CK level[(3841±3175),(549±338) U/L,respectively,P＜0.05] and muscle strength (15.1 ±2.4,18.1 ±0.9,respectively,P＜0.05) were assessed at the same time.Muscle strength grade was associated with signal score of MRI and serum CK level,there was a strong correlation between muscle strength grade and signal score of MRI(r=-0.890,P＜0.05 ).ConclusionMRI may be a useful tool for clinical efficacy evaluation in patients with polymyositis and dermatomyositis.
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Objective To evaluate the value of computed tomography(CT) and magnetic resonance imaging(MRI) in diagnosis of avascular necrosis of the femoral head(ANFH). Methods The literatures of ANFH diagnosed with CT and MR imaging published in the last ten years were collected by searching. Of that,21 literatures were correspond for the standards in this study and were select-ed. These literatures in diagnosing ANFH with CT and MR imaging were analysed with Meta-analysis by the sofeware of StataSE10.1. Results MRI was more effective than CT in diagnosing ANFH. There was significantly different in statistics between them [OR=0.13,95%CI(0.03～0.51)]. Conclusion In comparison with CT,MRI is the better method in diagnosing ANFH.
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Objective To assess the value of using MRI to evaluate the histopathological characteristic of limb soft-tissue aggressive fibromatosis (AF). Methods The MBI findings and histopathological data of 20 patients with AF were obtained and analyzed. The difference between the different signal regions in AF were compared of signal intensity in T1-weighted images, T2-weighted images and degree of enhancement. The data were processed with paired t test. The histopathology of different signal regions was observed in 6 cases on HE stain and Masson trichromic stain of AF specimen. Results (1) AF predominantly originated from the skeletal muscles (19/20), presenting as Iobulated mass with infiltrative growth(20/20) ;(2) A few claw-shaped neo-arteries(7/7) were delineated in the periphery of the mass in the 3D DCEMRA images as well as the mild tumor staining(7/7) ; (3) Based on the MRI findings, the porenchyma of 20 AF was divided into two distinct regions of structure: region Ⅰ and region Ⅱ. Region Ⅰ presented as hypointensity on both T1-weighted and T2-weighted images and no enhancement after i. v. administration of contrast. Region Ⅱ presented as mild hyperintensity on T2-weighted images and iso- or hypointensity on T1-weighted images and marked enhancement; (4) The signal intensity in T1-weighted images, T2-weighted images and degree of enhancement was 0. 10 ± 0. 02,0. 24 ± 0. 03, and ( 5.22 ± 0.42)% in region Ⅰ , respectively; and 0.79±0.04,3.05±0.08 and(151.5±8.61)% in region Ⅱ, respectively. The differences between region Ⅰ and region Ⅱ were statistically significant of signal intensity in T1-weighted images( t = 67. 37 ), and signal intensity in T2-weighted images( t = 196. 56) and degree of enhancement(t =76. 62) (P <0. 01 ) ; (5) Histologically, AF was composed of fibroblasts, fibrecytes and bundles of collagen fiber. On Massen triehromie stain, region Ⅰ was stained blue, being proven the mature collagen fibers. Region Ⅱ was predominantly composed of fibroblasts, fibrecytes and was not stained. Conclusion The region Ⅰ and region Ⅱ are the characteristic MRI manifestations of AF, and MBI precisely reflects the histopathological and biological feature of the tumor.
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Objective To explore the value of laparoscopic appendectomy (LA) in children. Methods A total of 52 children underwent laparoscopic appendectomy by using the 3-port technique from October 2002 to December 2004. Results The operations were performed smoothly in all the 52 cases. The operating time was 20~50 min (mean, 30 min). The patients were discharged from hospital at 2~4 postoperative days. Peri-port subcutaneous emphysema occurred in 2 cases. No other complications were found. Follow-up checkups for 3~29 months (mean, 14 months) in 49 cases found no intestinal obstruction or abdominal residual infection. Conclusions Laparoscopic appendectomy in children is safe, effective and minimally invasive.