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Transumbilical laparoscopic-assisted appendectomy as a safe procedure for pediatric uncomplicated appendicitis: a comparison with laparoscopic and open appendectomy in a randomized clinical trial

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Journal of Pediatric Endoscopic Surgery Aims and scope Submit manuscript

Abstract

Purpose

Deemed as a safe and easily performed procedure in children, transumbilical laparoscopic-assisted appendectomy (TULA) also offers several other advantages: reduced costs, a lower wound infection rate, fewer postoperative complications, and better cosmetic outcomes. The present investigation compares the results of three methods of appendectomies: 1-conventional, 2- laparoscopic, and 3- transumbilical laparoscopic-assisted.

Methods

The current study enrolled 210 patients and divided them into three groups of 70 each. Each group underwent one of the three methods of appendectomy. In TULA, the appendix exteriorized from the umbilicus laparoscopically, and then an extra-corporeal appendectomy was performed. The surgical approaches for the other two patient groups were standard techniques normally utilized in laparoscopic (LA) and open appendectomy (OA).

Results

In TULA, the mean operation length was significantly shorter than that in LA. Regarding scar size, the smallest were from the TULA group, with a significant difference in surgical wound size when compared with those of the other two groups. The length of the hospital stay was significantly shorter for TULA and LA patients than for OA patients. In addition, there was a lower wound infection rate associated with TULA than with LA and OA.

Conclusions

TULA is an alternative method of appendectomy in uncomplicated pediatric acute appendicitis. Compared to other approaches, TULA is technically easier, has a shorter operation time, offers better surgical outcomes, involves less surgical site infections, and results in excellent cosmetic results.

Trial registration

The trial is registered in the Iranian Registry of Clinical Trials (IRCT id: IRCT201703088375N12).

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Abbreviations

TULA:

Trans-umbilical laparoscopic-assisted appendectomy

OA:

Open appendectomy

LA:

Laparoscopic appendectomy

SILA:

Single incision laparoscopic appendectomy

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Acknowledgements

This investigation has been done in Imam Reza hospital, department of general surgery at Birjand University of medical sciences. It is approved by Ethics Committee of Birjand University of Medical Sciences, Reference number: Ir.bums.REC.1395.264. This manuscript is in Clinical trial category.

Funding

The source of funding for this research is vice chancellor for research, Birjand University of Medical Sciences.

Author information

Authors and Affiliations

  1. Department of General Surgery, Imam Reza Hospital, Birjand University of Medicine, Birjand, Iran

    S. A. K. Vejdan

  2. General Surgery Unit, Imam Reza Hospital, Taleghany St, Birjand, South Khorasan, Iran

    S. A. K. Vejdan

  3. Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran

    Malihe Khosravi

  4. Birjand University of Medical Sciences, Imam Reza Hospital, Birjand, Iran

    Z. Amirian

Authors
  1. S. A. K. Vejdan
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  2. Malihe Khosravi
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  3. Z. Amirian
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Corresponding author

Correspondence to S. A. K. Vejdan.

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Conflict of interest

This clinical trial doesn’t have any conflict of interest.

Ethical approval

In this investigation, all of the private patient’s information are blinded and there is nothing as potentially identifiable patient information.

Informed consent

Consent form is consisting of, detail of benefits and risks of three methods of surgeries and signed by all of the patients.

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Vejdan, S.A.K., Khosravi, M. & Amirian, Z. Transumbilical laparoscopic-assisted appendectomy as a safe procedure for pediatric uncomplicated appendicitis: a comparison with laparoscopic and open appendectomy in a randomized clinical trial. J Ped Endosc Surg 3, 39–46 (2021). https://doi.org/10.1007/s42804-020-00087-1

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  • DOI: https://doi.org/10.1007/s42804-020-00087-1

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