Laparoscopic Transumbilical Appendectomy in Nonperforated Appendicitis in Pediatric Age Group
Iranian Journal of Pediatric Surgery,
Vol. 6 No. 2 (2020),
7 December 2020
,
Page 81-91
https://doi.org/10.22037/irjps.v6i2.28835
Abstract
Introduction: Laparoscopic appendectomy has recently been trended to be performed by using a less trocar technique. In children, appendectomy is performed more by open approach; so this study was designed to compare benefits of non-invasive laparoscopic appendectomy with usual open technique.
Materials and Methods: After obtaining institutional review board approval, from 2015 to 2018, 73 children with acute, nonperforated appendicitis were treated by single-incision laparoscopic or open approach. The patients were randomized to two treatment groups: 36 patients underwent open operation, and 37 by laparoscopic approach via single-incision in umbilicus. 3 cases of laparoscopic approach were converted to open surgery and removed from the study. In patient selection, cases of complicated appendicitis confirmed by imaging modalities were excluded. The outcomes were investigated in both groups by length of operation, duration of hospital stay, presence of postoperative fever, wound infection, ileus after operation, and pelvic abscess after surgery.
Results: 73 appendectomies were carried out totally by single surgeon, 37 were single-incision laparoscopy and 36 underwent open procedure. Total anesthesia time and duration of operation showed significantly longer in the laparoscopic group. On the other hand, time to tolerate liquid diet was significantly shorter in the laparoscopic group. The duration of hospital stay showed similar duration in both groups. No mortality occurred in the study. Overall complications demonstrated no significant difference between two groups. Also there was no difference in infectious complications between the laparoscopic group and the open group
Conclusion: Our study suggests that Assisted Transumbilical laparoscopic appendectomy is a reasonable alternative to open surgery for appendicitis in acute none ruptured condition. All analyzed complications were similar between the groups, suggesting that Assisted Transumbilical laparoscopic appendectomy is a suitable ingrained method in pediatric cases with appendicitis
- appendectomy
- nonperforated appendicitis
- laparoscopy
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References
Stanfill AB, Matilsky Dk, Kalvakuri K, et al: Transumbilical Laparoscopically Assisted Appendectomy: An Alternative Minimally Invasive Technique in Pediatric Patients. Journal of laparoendoscopic & advanced surgical techniques 2010;20(10): 873-6.
Mohajerzadeh L, Rouzrokh M, Khaleghnejad Tabari A: Laparoscopic Appendectomy in Complicated Appendicitis of Children. Ann Colorectal Res 2014; 2(1): e16599.
Baik SM, Hong KS, Kim YI: A comparison of transumbilical single-port laparoscopic appendectomy and conventional three-port laparoscopic appendectomy: from the diagnosis to the hospital cost. J Korean Surg Soc 2013; 85(2): 68–74.
Mintz Y, Horgan S, Cullen J, et al: a review of the technical problems encountered and their solutions. J Laparoendosc Adv Surg Tech A 2008;18:583–587.
Katkhouda N, Mason RJ, Towfigh Sh: Laparoscopic Versus Open Appendectomy A Prospective Randomized Double-Blind Study. Annals of surgery 2005;242(3):439.
Tashiro J, Einstein SA, Perez EA, et al: Hospital preference of laparoscopic versus open appendectomy: Effects on outcomes in simple and complicated appendicitis. Journal of Pediatric Surgery 2016; 51 :804–809.
Carmine Noviello, Romano M, Martino A, et al: Transumbilical laparoscopic-assisted appendectomy in the treatment of acute uncomplicated appendicitis in children. Gastroenterology research and practice 2015; 949162.
Markar SR, Blackburn S, Cobb R, et al: Laparoscopic versus open appendectomy for complicated and uncomplicated appendicitis in children. Journal of Gastrointestinal Surgery 2012; 16: 1993-2004.
Cheong LH, Emil S: Pediatric laparoscopic appendectomy: a population-based study of trends, associations, and outcome. Journal of Pediatric Surgery 2014; 49: 1714-1718.
Minutolo V, Licciardello A, Di Stefano B, et al: Outcomes and cost analysis of laparoscopic versus open appendectomy for treatment of acute appendicitis: 4-years experience in a district hospital. BMC Surgery 2014;14:14.
Scire G, Mariotto A, Peretti M, et al: Laparoscopic versus open appendectomy in the management of acute appendicitis in children: a multicenter retrospective study. Minerva pediatrica 201 ; 66 : 281-285.
Zampieri N, Scirè G, Mantovani A, et al: Transumbilical laparoscopic-assisted appendectomy in children: Clinical and surgical outcomes. World journal of gastrointestinal endoscopy 2014; 6 :101-104.
Impellizzeri P, Simona A, Grasso M, et al: Surgical stress after open and transumbilical laparoscopic-assisted appendectomy in children. European Journal of Pediatric Surgery 2014; 24: 174-178.
Esposito C, Borzi P, Valla JS, et al: Laparoscopic versus open appendectomy in children: a retrospective comparative study of 2,332 cases. World Journal of Surgery 2007; 31 :750-755.
Ikeda H, Ishimaru Y, Takayasu H, et al: Laparoscopic versus open appendectomy in children with uncomplicated and complicated appendicitis 2004; 39: 1680-1685.
Pappalepore N, Turaini L, Marino N: Transumbilical laparoscopic assisted appendectomy (TULAA): a safe and useful alternative for uncomplicated appendicitis. European Journal of Pediatric Surgery 2001; 12 : 383-386.
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