Abstract
Background: This pilot study was performed to reassess the widespread postulate that laparoscopic surgery is contraindicated in cases of perforating appendicitis.
Methods: A total of 75 children (appendiceal perforation: n= 67; perityphlic abscesses and peritonitis: n= 8) were analyzed in a prospective nonrandomized trial. Ten of them were treated by laparoscopic appendectomy.
Results: In the laparoscopy group, both pain and hospitalization were less time-consuming (i.e., by 50% and 19%, respectively). Antibiotics use was down from 2.6 over 6 days to 2.2. over 5.5 days, while the duration of surgery was up by 52%. Wound healing disturbances occurred in 10% (n= 1) and postoperative fever in 50% (n= 5) of patients, compared to 14% (n= 9) and 15% (n= 10) in the group treated by open surgery. All severe complications requiring reintervention (10%; massive subcutaneous abscess, n= 3; retrocolic abscess, n= 2; adhesion-related ileus, n= 3; appendicular stump, n= 1) were associated with open surgery.
Conclusions: There was not a single major complication in the laparoscopy group. These unexpected results are in contrast to previous reports and have prompted us to initiate a prospective randomized trial.
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Received: 27 August 1998/Accepted: 20 January 1999
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Paya, K., Rauhofer, U., Rebhandl, W. et al. Perforating appendicitis. Surg Endosc 14, 182–184 (2000). https://doi.org/10.1007/s004649900096
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DOI: https://doi.org/10.1007/s004649900096