Comparison of Open and Laparoscopic Appendectomy in Children: A 5-year Single Center Experience.

OBJECTIVE

To compare the outcomes of treatment in children with acute appendicitis between laparoscopic and open surgical approaches.

DESIGN

Retrospective study.

SETTING

Division of Pediatric Surgery at a tertiary-care hospital in Croatia between January 2012 to December 2016.

PATIENTS

834 children [median (IQR) age 13 (11,15)] who underwent appendectomy; 301 in the laparoscopic group and 533 in the open group.

MAIN OUTCOME MEASURES

Postoperative complications, duration of hospitalization, re-operation, and the quantity of analgesics used.

RESULTS

The median length of hospital stay was 3 days in laparoscopic group compared to 6 days in open group (P<0.001). The amount of analgesics used was lower in patients with laparoscopic appendectomy compared to patients who underwent open procedure (P=0.042). Significantly higher number of wound infections was recorded in the open group (n=21; 3.9%) compared to laparoscopic group (n=3; 1%) (P=0.014). The frequency of re-operation in both groups was equal (1.3%). The median duration of surgery was shorter in the group of patients with laparoscopic appendectomy compared to the open approach (30 vs. 45 min; P<0.001). In five-year period, the proportion of laparoscopic appendectomies increased by 21.5%.

CONCLUSIONS

Laparoscopic appendectomy was safe and effective in children. Advantages of laparoscopic approach were shorter hospital stay, lower number of wound infections and lower usage of analgesics.