Appendicitis Research Today is a free monthly online journal that collates and summarizes the latest research about Appendicitis, including details on symptoms, surgery, causes, treatment. | ||||||||
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Laparoscopic versus open appendectomy in children: outcomes comparison based on a statewide analysis.Jen HC, Shew SB Division of Pediatric Surgery, Mattel Children's Hospital, David Geffen School of Medicine at UCLA, Los Angeles, California 90095-7098, USA. BACKGROUND: To compare the differences in hospital utilization and complications between laparoscopic (LA) and open appendectomy (OA) for pediatric appendicitis. METHODS: A retrospective study from 1999 to 2006 of children aged 1 to 18 y with appendicitis, from the California Patient Discharge Database was performed. Children with significant comorbidities were excluded. Initial hospital course, subsequent readmissions, and the need for additional procedures were analyzed. RESULTS: The use of LA increased steadily from 19% in 1999 to 52% in 2006. Overall, 95,806 children were studied. Readmissions were tracked over a median period of 3 y. LA was associated with increased need for postoperative intra-abdominal abscess drainage for both perforated appendicitis (4.9% versus 3.8%, P<0.001) and nonperforated appendicitis (0.6% versus 0.3%, P<0.001) compared with OA. Multivariate regression showed an increased risk of postoperative abscess drainage for children after LA compared with OA (RR 1.81, 99% CI 1.41-2.27). However, the lengths of readmission hospitalizations were the same between the two groups (5.8 versus 5.7 d, P=NS). CONCLUSION: LA has become the preferred operation for pediatric appendicitis. The need for postoperative abscess drainage is small, and laparoscopy appears to increase this risk slightly. However, LA did not affect long-term hospital utilizations. Published 3 May 2010 in J Surg Res, 161(1): 13-7.
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