Laparoscopic Versus Open Appendectomy for Perforated Appendicitis in Children

Park, Jae Young; Choe, Yun Mee; Yun, Min Young; Choi, Sun Keun; Hur, Yoon Seok; Lee, Keon Young; Kim, Sei Joong; Cho, Young Up; Ahn, Seung Ik; Hong, Kee Chun; Shin, Seok Hwan; Kim, Kyung Rae

Abstract

PURPOSE: Appendectomy is the most common emergent surgical operation in children. Laparoscopic appendectomy is currently a popular procedure in children, but pediatric laparoscopic appendectomy is controversial for its efficacy and safety, especially for perforated appendicitis. We compared the efficacy and safety between laparoscopic appendectomy (LA) and open appendectomy (OA) for treating perforated appendicitis of children.
METHODS
This study involved a total of 69 patients who underwent appendectomy for perforated appendicitis at our institution between March 2005 and September 2007, and these patients were less than 15 years old. There were 41 patients in the LA group and 28 patients in the OA group. The demographic data, operative time, length of the hospital stay, bowel movement, pain control and complications were assessed.
RESULTS
There was no significant difference between the LA and OA groups with respect to gender, age, the operation time, the length of the hospital stay, bowel movement and pain control. There was one complication (2.4%) in the LA group and four complications (16.6%) in the OA group, but there was no significant difference (P=0.062). There was no wound infection.
CONCLUSION
Laparoscopic appendectomy for the children with perforated appendicitis is a safe procedure. Yet we need further high quality randomized trials to compare the 2 techniques.