Laparoscopic Appendectomy in Children-Study of 331 Cases and Analysis of Outcome

Abstract

Objective: The aim of this study was to present the experience of 331 cases treated by laparoscopic appendectomy in children operated by single pediatric surgeon and to analyze the outcome. Study Design: A descriptive retrospective study design Place and Duration of Study: All the children treated by laparoscopic appendectomy between period of June 15, 2011, to October 15, 2021 at Northern Area Armed Forces Hospital, Hafr al Batin, Saudi Arabia. Materials and Methods: This was a retrospective study of 331 cases of acute appendicitis in children treated by laparoscopic appendectomy between the period of June 15, 2011, to Oct 15, 2021. Acute appendicitis was diagnosed on clinical basis supported by lab tests including leukocytosis and increased neutrophils count and occasionally by radiological studies including AXR showing fecalith, ultrasound abdomen showing free pelvic fluid and CT scan abdomen with thick walled or perforated appendix. All cases were operated by the same pediatric surgeon. Patient's gender, age, weight, clinical symptoms and signs, laboratory and radiological data, results of surgical treatment, operative and post-operative complications and outcome were studied. The electronic data of the operation room was collected and analyzed by the operating pediatric surgeon with permission from the hospital ethical committee. The outcome of laparoscopic appendectomy was analyzed. Results: Three hundred and thirty-three children with acute appendicitis were treated by laparoscopic appendectomy. There were 199 males and 132 female patients. The mean age was 10 years (1 to 14 years). The mean surgery time was 45 minutes. The peritoneal suction -wash was performed in 300 cases and drainage of peritoneal cavity was done in 3 cases of perforated appendicitis. No conversion to open appendectomy was done in this series. The rate of operative and post-operative complications was zero percent. The overall incidence of postoperative wound infection was low (<1%). All the children resumed normal daily activities after 7 days of average time. The families and the children were found satisfied with the outcome. Conclusion: Laparoscopic appendectomy in children is a feasible, effective, safe and appropriate procedure in the treatment of acute appendicitis in children with excellent cosmetic outcome.

Keywords

• acute abdomen, acute appendicitis, laparoscopic appendectomy, complications, follow up.