Department of Surgery, Madigan Army Medical Center, Tacoma, WA 98431, USA.
J Pediatr Surg. 2013 Sep;48(9):1941-5. doi: 10.1016/j.jpedsurg.2012.12.039.
To examine the trends in laparoscopic appendectomy (LA) utilization and outcomes for children 5 years or younger.
We studied 16,028 inpatient admissions for children 5 years of age or less undergoing an appendectomy for acute appendicitis in 2000, 2003, and 2006 using the Kids' Inpatient Database (KID). Laparoscopy frequency, hospital length of stay, and complications were reviewed.
In 2000, 2003 and 2006 appendectomies were done laparoscopically 11.4%, 18.7% and 31.3% of the time, respectively. Children were more likely to undergo LA at a children's hospital (P<0.001). LA complications were less likely overall (OR: 0.80, CI: 0.70-0.92, P=0.002) and in perforated cases (OR: 0.78, CI: 0.67-0.91, P=0.001). LA decreased hospital length of stay by 0.54 days for all patients and 0.70 days for perforated cases (P<0.001).
Open appendectomy has historically been the standard in children 5 years of age and younger. Laparoscopic appendectomy has slowly gained acceptance for the treatment of appendicitis in smaller children. The use of laparoscopy has increased significantly at all facilities. Furthermore, laparoscopic appendectomy in this age group has a comparatively low complication rate and short hospital length of stay, and is safe in complicated perforated appendicitis cases.
研究 5 岁及以下儿童腹腔镜阑尾切除术（LA）的应用趋势和结局。
我们使用儿童住院数据库（KID）研究了 2000 年、2003 年和 2006 年期间 16028 名 5 岁及以下因急性阑尾炎行阑尾切除术的住院患儿。回顾了腹腔镜手术的频率、住院时间和并发症。
2000 年、2003 年和 2006 年，腹腔镜阑尾切除术分别占 11.4%、18.7%和 31.3%。儿童在儿童医院更有可能接受 LA（P<0.001）。LA 总体并发症的可能性较小（OR：0.80，CI：0.70-0.92，P=0.002），穿孔病例的并发症可能性较小（OR：0.78，CI：0.67-0.91，P=0.001）。LA 使所有患者的住院时间缩短了 0.54 天，穿孔病例的住院时间缩短了 0.70 天（P<0.001）。
开放性阑尾切除术一直是 5 岁及以下儿童的标准治疗方法。腹腔镜阑尾切除术已逐渐被接受用于治疗较小儿童的阑尾炎。腹腔镜的使用在所有医疗机构中都显著增加。此外，该年龄段的腹腔镜阑尾切除术的并发症发生率和住院时间相对较短，在复杂穿孔性阑尾炎病例中是安全的。
