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Laparoscopic appendectomy for perforated appendicitis: a comparison with open appendectomy

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Abstract

Background

The role of laparoscopic appendectomy for perforated appendicitis remains controversial. This study aimed to compare laparoscopic and open appendectomy outcomes for children with perforated appendicitis.

Methods

Over a 36-month period, 111 children with perforated appendicitis were analyzed in a retrospective review. These children were treated with either laparoscopic (n = 59) or open appendectomy. The primary outcome measures were operative time, length of hospital stay, time to adequate oral intake, wound infection, intraabdominal abscess formation, and bowel obstruction.

Results

The demographic data, presenting symptoms, preoperative laboratory values, and operative times (laparoscopic group, 61 ± 3 min; open group, 57 ± 3 were similar for the two groups (p = 0.3). The time to adequate oral intake was 104 ± 7 h for the laparoscopic group and 127 ± 12 h for the open group (p = 0.08). The hospitalization time was 189 ± 14 h for the laparoscopic group, as compared with 210 ± 15 h for the open group (p = 0.3). The wound infection rate was 6.8% for the laparoscopic group and 23% for the open group (p < 0.05). The wounds of another 29% of the patients were left open at the time of surgery. The postoperative intraabdominal abscess formation rate was 13.6% for the laparoscopic group and 15.4% for the open group. One patient in each group experienced bowel obstruction.

Conclusions

Laparoscopic appendectomy for the children with perforated appendicitis in this study was associated with a significant decrease in the rate of wound infection. Furthermore, on the average, the children who underwent laparoscopic appendectomy tolerated enteral feedings and were discharged from the hospital approximately 24 h earlier than those who had open appendectomy.

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References

  1. Addiss DG, Shaffer N, Fowler BS, Tauxe RV (1990) The epidemiology of appendicitis and appendectomy in the United States. Am J Epidemiol 132: 910–925

    PubMed  CAS  Google Scholar 

  2. Surana R, Puri P (1994) Primary wound closure after perforated appendicitis in children. Br J Surg 81: 440. No abstract available

    PubMed  CAS  Google Scholar 

  3. Brender JD, Marcuse EK, Koepsell TD, Hatch EI (1985) Childhood appendicitis: factors associated with perforation. Pediatrics 76: 301–306

    PubMed  CAS  Google Scholar 

  4. Pearl RH, Hale DA, Molloy M, Schutt DC, Jaques DP (1995) Pediatric appendectomy. J Pediatr Surg 30: 173–178

    Article  PubMed  CAS  Google Scholar 

  5. Fishman SJ, Pelosi L, Klavon SL, O’Rourke EJ (2000) Perforated appendicitis: prospective outcome analysis for 150 children. J Pediatr Surg 35: 923–926

    Article  PubMed  CAS  Google Scholar 

  6. Semm K (1983) Endoscopic appendectomy. Endoscopy 15: 59–64

    PubMed  CAS  Google Scholar 

  7. Paya K, Fakhari M, Rauhofer U, Felberbauer FX, Rebhandl W, Horcher E. (2000) Open versus laparoscopic appendectomy in children: a comparison of complications. Journal of the Society of Laparoendoscopic Surgeons 4: 121–124

    PubMed  CAS  Google Scholar 

  8. Frazee RC, Bohannon WT (1996) Laparoscopic appendectomy for complicated appendicitis. Arch Surg 131: 509–511

    PubMed  CAS  Google Scholar 

  9. Canty TG Sr, Collins D, Losasso B, Lynch F, Brown C (2000) Laparoscopic appendectomy for simple and perforated appendicitis in children: the procedure of choice? J Pediatr Surg 35: 1582–1585

    Article  PubMed  Google Scholar 

  10. Kokoska ER, Murayama KM, Silen ML, Miller TA, Dillon PA, Weber TR (1999) A state-wide evaluation of appendectomy in children. Am J Surg 178: 537–540

    Article  PubMed  CAS  Google Scholar 

  11. Steyaert H, Hendrice C, Lereau L, Hayem C, el Ghoneimi A, Valla JS (1999) Laparoscopic appendectomy in children: sense or nonsense? Acta Chir Belg 99: 119–124

    PubMed  CAS  Google Scholar 

  12. Stoltzing H,Thon K (2000) Perforated appendicitis: is laparocopic operation advisable? Dig Surg 17: 610–616

    Article  PubMed  CAS  Google Scholar 

  13. Little DC, Custer MD, May BH, Blalock SE, Cooney DR (2002) Laparoscopic appendectomy: An unnecessary and expensive procedure in children? J Pediatr Surg 37: 310–317

    Article  PubMed  Google Scholar 

  14. Lavonius MI, Liesjarvi S, Ovaska J, Pajulo O, Ristkari S, Alanen M (2001) Laparoscopic versus open appendectomy in children: a prospective randomised study. Eur J Pediatr Surg 11: 235–238

    Article  PubMed  CAS  Google Scholar 

  15. Lintula H, Kokki H, Vanamo K (2001) Single blind randomized clinical trial of laparoscopic versus open appendicectomy in children. Br J Surg 88: 510–514

    Article  PubMed  CAS  Google Scholar 

  16. Meguerditchian AN, Prasil P, Cloutier R, Leclerc S, Peloquin J, Roy G (2002) Laparoscopic appendectomy in children: A favorable alternative in simple and complicated appendicitis. J Pediatr Surg 37: 695–698

    Article  PubMed  Google Scholar 

  17. Paya K, Rauhofer U, Rebhandl W, Deluggi S, Horcher E (2000) Perforating appendicitis. An indication for laparoscopy? Surg Endosc 14: 182–184

    Article  PubMed  CAS  Google Scholar 

  18. Chung RS, Rowland DY, Li P, Diaz J (1999) A meta-analysis of randomized controlled trials of laparoscopic versus conventional appendectomy. Am J Surg 177: 250–256

    Article  PubMed  CAS  Google Scholar 

  19. Jess P (1983) Acute appendicitis: epidemiology, diagnostic accuracy, and complications. Scand J Gastroenterol 18: 161–163

    Article  PubMed  CAS  Google Scholar 

  20. Katkhouda N, Friedlander MH, Grant SW, Achanta KK, Essani R, Paik P,Velmahos G, Campos G, Mason R, Mavor E (2000) Intraabdominal abscess rate after laparoscopic appendectomy. Am J Surg 180: 456–459; discussion 460–461

    Article  PubMed  CAS  Google Scholar 

  21. Reid RI, Dobbs BR, Frizelle FA (1999) Risk factors for postappendicectomy intraabdominal abscess. Aust NZ J Surg 69: 373–374

    Article  CAS  Google Scholar 

  22. Temple LK, Litwin DE, McLeod RS (1999) A metaanalysis of laparoscopic versus open appendectomy in patients suspected of having acute appendicitis. Can J Surg 42: 377–383

    PubMed  CAS  Google Scholar 

  23. Ortega AE, Hunter JG, Peters JH, Swanstrom LL, Schirmer B (1995) A prospective, randomized comparison of laparoscopic appendectomy with open appendectomy. Laparoscopic Appendectomy Study Group. Am J Surg 169: 208–212

    Article  PubMed  CAS  Google Scholar 

  24. Lejus C, Delile L, Plattner V, Baron M, Guillou S, Heloury Y, Souron R (1996) Randomized, single-blinded trial of laparoscopic versus open appendectomy in children: effects on postoperative analgesia. Anesthesiology 84: 801–806

    Article  PubMed  CAS  Google Scholar 

  25. Ure BM, Spangenberger W, Hebebrand D, Eypasch EP, Troidl H (1992) Laparoscopic surgery in children and adolescents with suspected appendicitis: results of medical technology assessment. Eur J Pediatr Surg 2: 336–340

    Article  PubMed  CAS  Google Scholar 

  26. Tate JJ, Chung SC, Dawson J, Leong HT, Chan A, Lau WY, Li AK (1993) Conventional versus laparoscopic surgery for acute appendicitis. Br J Surg 80: 761–764

    PubMed  CAS  Google Scholar 

  27. Khalili TM, Hiatt JR, Savar A, Lau C, Margulies DR (1999) Perforated appendicitis is not a contraindication to laparoscopy. Am Surg 65(10): 965–967

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Pediatric Surgery, Ankara University School of Medicine, Dikimevi, Ankara, 06100, Turkey

    A. Yagmurlu

  2. Division of Pediatric Surgery, Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA

    A. Vernon, D. C. Barnhart, K. E. Georgeson & C. M. Harmon

Authors
  1. A. Yagmurlu
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  2. A. Vernon
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  3. D. C. Barnhart
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  4. K. E. Georgeson
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  5. C. M. Harmon
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Correspondence to A. Yagmurlu.

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Yagmurlu, A., Vernon, A., Barnhart, D.C. et al. Laparoscopic appendectomy for perforated appendicitis: a comparison with open appendectomy. Surg Endosc 20, 1051–1054 (2006). https://doi.org/10.1007/s00464-005-0342-z

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  • DOI: https://doi.org/10.1007/s00464-005-0342-z

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