Comparison of Open and Laparoscopic Appendectomy in Children: A 5-year Single Center Experience – Zenon Pogorelic, Mia Buljubasic, Tomislav Susnjar, Miro Jukic, Tina Poklepovic Pericic and Ivo Juric

ABSTRACT

Objective: To compare the outcomes of treatment in childrenwith acute appendicitis between laparoscopic and open surgicalapproaches.Design: Retrospective study.Setting: Division of Pediatric Surgery at a tertiary-care hospitalin Croatia between January 2012 to December 2016.Patients 834 children [median (IQR) age 13 (11,15)] whounderwent appendectomy; 301 in the laparoscopic group and 533in the open group.Main outcome measures: Postoperative complications,duration of hospitalization, re-operation, and the quantity ofanalgesics used.Results: The median length of hospital stay was 3 days inlaparoscopic group compared to 6 days in open group (P<0.001).The amount of analgesics used was lower in patients withlaparoscopic appendectomy compared to patients whounderwent open procedure (P=0.042). Significantly highernumber 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 wasequal (1.3%). The median duration of surgery was shorter in thegroup of patients with laparoscopic appendectomy compared tothe open approach (30 vs. 45 min; P<0.001). In five-year period,the proportion of laparoscopic appendectomies increased by21.5%.Conclusion: Laparoscopic appendectomy was safe andeffective in children. Advantages of laparoscopic approachwere shorter hospital stay, lower number of wound infectionsand lower usage of analgesics.