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Laparoscopic Versus Open Appendectomy for Acute Appendicitis in Children: a Nationwide Retrospective Study on Postoperative Outcomes

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Purpose

Our aim was to compare postoperative outcomes of laparoscopic and open appendectomies for acute appendicitis in children under the circumstance of widespread use of laparoscopic surgery.

Method

This study included data on laparoscopic and open appendectomies in children with acute appendicitis from the National Clinical Database, which is a Japanese nationwide surgical database, in 2015. The occurrence rates of complications within 30 days after the surgery and postoperative hospital stay were compared by univariate and multivariate analyses. p < 0.05 was considered statistically significant.

Results

This study included 4489 appendectomies, of which 3166 surgeries (70.5%) were performed laparoscopically. Appendectomy was performed for complicated and uncomplicated appendicitis in 1765 (39.3%) and 2724 cases (60.7%), respectively. Postoperative complications within 30 days were observed in 246 operations (5.5%). Organ-space surgical site infection (SSI), deep wound SSIs, and superficial wound SSIs were observed in 2.3%, 1.0%, and 2.4% of operations, respectively. On multivariate analysis, the incidence of postoperative complications (odds ratio 1.21, 95% CI 0.90–1.64, p = 0.207) and the length of hospital stay (median 4 days in both groups, p = 0.835) were not significantly different between patients who underwent laparoscopic or open appendectomy. Subgroup analysis in complicated and uncomplicated appendicitis cases also demonstrated no significant differences in the incidence of postoperative complications between those who underwent laparoscopic or open appendectomy.

Conclusion

This study suggested that the occurrence of postoperative complication and the length of hospital stay in pediatric patients who underwent laparoscopic appendectomy are similar with those in pediatric patients who underwent open appendectomy for acute appendicitis.

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Presentation at a Scientific Meeting

This paper was based on an abstract presented at the 51st annual scientific meeting of the Pacific Association of Pediatric Surgeons, May 13–17, 2018, in Sapporo, Japan.

Funding

This work was supported by JSPS KAKENHI (Grant-in-Aid for Scientific Research (C) Grant Number JP16K11340).

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Authors and Affiliations

  1. Department of Pediatric Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan

    Jun Fujishiro, Eiichiro Watanabe & Tetsuya Ishimaru

  2. Former Database committee, The Japanese Society of Pediatric Surgeons, Yunizo Urban Koishikawa Bldg. 4F, Otsuka 5-3-13, Bunkyo-ku, Tokyo, 112-0012, Japan

    Jun Fujishiro, Eiichiro Watanabe, Norimichi Hirahara, Keita Terui & Hirofumi Tomita

  3. The committee on the NCD, The Japanese Society of Pediatric Surgeons, Yunizo Urban Koishikawa Bldg. 4F, Otsuka 5-3-13, Bunkyo-ku, Tokyo, 112-0012, Japan

    Jun Fujishiro, Eiichiro Watanabe, Norimichi Hirahara, Keita Terui & Hirofumi Tomita

  4. The National Clinical Database, Segawa Bldg. 9F, Kandasurugadai 2-8, Chiyoda-ku, Tokyo, 101-0062, Japan

    Norimichi Hirahara & Hiroaki Miyata

Authors
  1. Jun Fujishiro
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  2. Eiichiro Watanabe
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  3. Norimichi Hirahara
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  4. Keita Terui
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  5. Hirofumi Tomita
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  6. Tetsuya Ishimaru
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  7. Hiroaki Miyata
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Contributions

Conception of the study: JF, EW, TI. Analysis and interpretation: JF, EW, NH, KT, HT, HM. Drafting the manuscript: JF. Reviewing the manuscript: JF, EW, NH, KT, HT, TI, HM.

Corresponding author

Correspondence to Jun Fujishiro.

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The authors declare that they have no conflicts of interest.

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Fujishiro, J., Watanabe, E., Hirahara, N. et al. Laparoscopic Versus Open Appendectomy for Acute Appendicitis in Children: a Nationwide Retrospective Study on Postoperative Outcomes. J Gastrointest Surg 25, 1036–1044 (2021). https://doi.org/10.1007/s11605-020-04544-3

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  • DOI: https://doi.org/10.1007/s11605-020-04544-3

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