Laparoscopic Appendectomy for Acute Appendicitis in Children: A Comparison with Open Appendectomy

ABSTRACT

PURPOSE: The advantage of a laparoscopic appendectomy for acute appendicitis in children is controversial, with no consensus among most pediatric surgeons, particularly with regard to the operative time and hospital costs in complicated cases. The objective of this study was to examine the safety, efficacy and complications of a laparoscopic appendectomy in children compared with an open appendectomy. METHODS: Our clinical experiences of laparoscopic appendectomy (LA) and open appendectomy (OA) for simple appendicitis (SA), complicated appendicitis (CA) and no evidence of appendicitis (NA) in children, between November, 2003 and October, 2006, were reviewed. Ninety- three (93) patients underwent a LA (58 boys, 35 girls) and 194 patients an OA (128 boys, 66 girls). The mean ages of the patients having undergone LA and OA were 9.6 and 8.9 years, respectively. RESULTS: The mean operation times were similar between the LA and OA in the SA and NA groups, but was shorter for a LA than an OA in the CA group, which was also statistically significant (P=0.007). There were statistically significant differences in the postoperative duration of hospital stay between a LA and an OA in all groups (in SA, 2.8 versus 4.5 days, P<0.001 and in CA, 4.5 versus 8.4 days, P<0.001). The rates of postoperative complications were different between a LA and an OA were for the SA group, 1.7 versus 1.0%, P=1.000; for the CA group, 0 versus 22.4%, P=0.006. CONCLUSION: Our experiences suggest that a laparoscopic appendectomy was a safe and effective procedure for any type of appendicitis in children, with a shorter hospital stay and lower rate of postoperative complications.