A comparative study between laparoscopic and open appendectomy for acute appendicitis in children / 中国微创外科杂志

ABSTRACT

Objective To compare effects between laparoscopic appendectomy(LA) and open appendectomy(OA) for acute appendicitis in children.Methods A total of 95 children with acute appendicitis from July 2000 to July 2005 were given either LA(LA Group,n=50) or OA(OA Group,n=45).The surgical outcomes and curative effects were compared between the two groups.Results The operation was successfully completed in both of the groups.No bleeding,intestinal fistula,or stump appendicitis was seen.There was no difference in the operation time between the LA Group(38.8?17.4 min) and the OA Group(41.9?15.8 min)(t=-0.905,P=0.368).The time to first defecation was significantly shorter in the LA Group(26.4?7.2 h) than in the OA Group(39.7?8.8 h)(t=-8.094,P=0.000).Appendiceal perforation was found in 29 children in the LA Group and 26 children in the OA Group,without significant difference(?~2=1.633,P=0.983),but the incidence of wound infection was significantly higher in the OA Group(11 children) than in the LA Group(2 children)(?~2=8.381,P=0.004).A drainage placement was required in 3 children in the LA Group and 9 children in the OA Group,with significant difference(?~2=4.206,P=0.040).The LA Group had significantly shorter time to normal temperature(55.4?16.2 h) than the OA Group(77.8?30.6 h)(t=-4.522,P=0.000),shorter hospital stay(5.4?1.3 d) than the OA Group(13.4?6.5 d)(t=-8.520,P=0.000),but higher hospitalization costs(6 117.9?836.5 yuan) than the OA Group(4 528.6?527.1 yuan)(t=10.937,P=0.000).Conclusions Laparoscopic appendectomy is superior to open surgery for acute appendicitis in children because of its advantages of minimal invasion,little pain,early recovery,good cosmetic appearance,low complication rate,and short hospital stay.