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Pediatric appendectomy: the outcome differences between pediatric surgeons and general surgeons

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Abstract

Purpose

The aim of this study was to review our experience of pediatric appendectomy performed by either a general surgeon (GS) or a pediatric surgeon (PS) to determine any differences in outcomes.

Methods

We reviewed the medical records of pediatric appendicitis patients, 4 years before (GS group, 2007–2010) and after (PS group, 2011–2014) the introduction of a pediatric surgical practice. The records were reviewed for the following variables: operation time, length of hospital stay, complications, readmission in ≤30 days, type of operation, negative for appendicitis, drainage, open conversion, and reoperation in ≤30 days.

Results

Over 8 years, 400 patients were operated on for acute appendicitis, with the PS group comprising 61 % (N = 244) of patients. The operation time (55.1 vs 43.2 min, p = 0.0001) and postoperative length of hospital stay (3.5 vs 2.7 days, p = 0.001) were shorter, more patients were treated by laparoscopy (61.3 vs 91.2 %, p = 0.0001), and a fewer patients required peritoneal drainage (29.5 vs 63.2 %, p = 0.023) in the PS group than in the GS group. The negative appendectomy rate was slightly lower in the PS group, but not to a statistically significant degree.

Conclusion

The patients in the PS group enjoyed a reduced operation time and length of hospital stay, greater likelihood of laparoscopic operation, and less peritoneal drainage than the patients in the GS group.

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References

  1. Markel TA, Rescorla FJ. A survey of the pediatric surgery program directors: optimizing resident research to make pediatric surgery training more efficient. J Pediatr Surg. 2015;50:1053–7.

    Article  PubMed  Google Scholar 

  2. Borenstein SH, To T, Wajja A, Langer JC. Effect of subspecialty training and volume on outcome after pediatric inguinal hernia repair. J Pediatr Surg. 2005;40:75–80.

    Article  PubMed  Google Scholar 

  3. Ly DP, Liao JG, Burd RS. Effect of surgeon and hospital characteristics on outcome after pyloromyotomy. Arch Surg. 2005;140:1191–7.

    Article  PubMed  Google Scholar 

  4. Dunn JC. Appendicitis. In: Coran AG, Adzick NS, Krummel TM, Laberge JM, Shamberger RC, Caldamone AA, editors. Pediatric surgery. 7th ed. Philadelphia: Elsevier; 2012. p. 1255–63.

    Chapter  Google Scholar 

  5. Emil SG, Taylor MB. Appendicitis in children treated by pediatric versus general surgeons. J Am Coll Surg. 2007;204:34–9.

    Article  PubMed  Google Scholar 

  6. Alexander F, Magnuson D, DiFiore J, Jirousek K, Secic M. Specialty versus generalist care of children with appendicitis: an outcome comparison. J Pediatr Surg. 2001;36:1510–3.

    Article  CAS  PubMed  Google Scholar 

  7. da Silva PS, de Aguiar VE, Waisberg J. Pediatric surgeon vs general surgeon: does subspecialty training affect the outcome of appendicitis? Pediatr Int. 2014;56:248–53.

    Article  PubMed  Google Scholar 

  8. Mizrahi I, Mazeh H, Levy Y, Karavani G, Ghanem M, Armon Y, et al. Comparison of pediatric appendectomy outcomes between pediatric surgeons and general surgery residents. J Surg Res. 2013;180:185–90.

    Article  PubMed  Google Scholar 

  9. Somme S, To T, Langer JC. Effect of subspecialty training on outcome after pediatric appendectomy. J Pediatr Surg. 2007;42:221–6.

    Article  PubMed  Google Scholar 

  10. Marzuillo P, Germani C, Krauss BS, Barbi E. Appendicitis in children less than five years old: a challenge for the general practitioner. World J Clin Pediatr. 2015;4:19–24.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Cheong LH, Emil S. Pediatric laparoscopic appendectomy: a population-based study of trends, associations, and outcomes. J Pediatr Surg. 2014;49:1714–8.

    Article  PubMed  Google Scholar 

  12. Masoomi H, Mills S, Dolich MO, Ketana N, Carmichael JC, Nguyen NT, et al. Comparison of outcomes of laparoscopic versus open appendectomy in children: data from the Nationwide Inpatient Sample (NIS), 2006–2008. World J Surg. 2012;36:573–8.

    Article  PubMed  Google Scholar 

  13. Akkoyun I, Tuna AT. Advantages of abandoning abdominal cavity irrigation and drainage in operations performed on children with perforated appendicitis. J Pediatr Surg. 2012;47:1886–90.

    Article  PubMed  Google Scholar 

  14. Narci A, Karaman I, Karaman A, Erdoğan D, Cavuşoğlu YH, Aslan MK, et al. Is peritoneal drainage necessary in childhood perforated appendicitis? A comparative study. J Pediatr Surg. 2007;42:1864–8.

    Article  PubMed  Google Scholar 

  15. Heel KA, Hall JC. Peritoneal defences and peritoneum-associated lymphoid tissue. Br J Surg. 1996;83:1031–6.

    Article  CAS  PubMed  Google Scholar 

  16. Song RY, Jung K. Drain insertion after appendectomy in children with perforated appendicitis based on a single-center experience. Ann Surg Treat Res. 2015;88:341–4.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Bonanni F, Reed J 3rd, Hartzell G, Trostle D, Boorse R, Gittleman M, et al. Laparoscopic versus conventional appendectomy. J Am Coll Surg. 1994;179:273–8.

    CAS  PubMed  Google Scholar 

  18. el Ghoneimi A, Valla JS, Limonne B, Valla V, Montupet P, Chavrier Y, et al. Laparoscopic appendectomy in children: report of 1379 cases. J Pediatr Surg. 1994;29:786–9.

    Article  PubMed  Google Scholar 

  19. Kim Y, Kang G, Moon SB. Increasing utilization of abdominal CT in the Emergency Department of a secondary care center: does it produce better outcomes in caring for pediatric surgical patients? Ann Surg Treat Res. 2014;87:239–44.

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgments

This study was supported by a 2014 Research Grant from Kangwon National University (Grant no. 520150337).

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Author notes

    Authors and Affiliations

    1. Department of Surgery, Kangwon National University School of Medicine, Chuncheon, 200-722, South Korea

      Younglim Kim & Suk-Bae Moon

    2. Department of Surgery, Seoul National University Bundang Hospital, Songnam, South Korea

      Kyuwhan Jung

    3. Department of Pathology, Kangwon National University School of Medicine, Chuncheon, South Korea

      Young-Joon Ryu

    Authors
    1. Younglim Kim
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    2. Kyuwhan Jung
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    3. Young-Joon Ryu
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    4. Suk-Bae Moon
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    Corresponding author

    Correspondence to Suk-Bae Moon.

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    The authors declare no conflicts of interest in association with this study.

    Additional information

    Y. Kim and K. Jung contributed equally to this work.

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    Kim, Y., Jung, K., Ryu, YJ. et al. Pediatric appendectomy: the outcome differences between pediatric surgeons and general surgeons. Surg Today 46, 1181–1186 (2016). https://doi.org/10.1007/s00595-016-1343-3

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    • DOI: https://doi.org/10.1007/s00595-016-1343-3

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