Comparison of clinical results of open and laparoscopic appendectomy in the treatment of acute and chronic appendicitis in pediatric patients
Clinic for Pediatric Surgery, Clinic Center of University, Sarajevo, Bosnia and Herzegovina
Worldwide Medicine 2019; 1(4): 101-113 | DOI: 10.5455/ww.49649 PDF
Background: Approximately 7-10% of the total population develops appendicitis during their lifetime, so that appendectomy is the most often performed abdominal surgery. For over a century, the golden standard in the treatment of patients with acute appendicitis was an open appendectomy. However, today many polemics among researchers are guided by whether, in pediatric population, the laparoscopic approach is superior to an open appendectomy.
Methods: A retrospective, clinical, comparative study was carried out covering 293 patients with an appendectomy in the period from November 2015 to April 2018 at the Clinical Center of the University of Sarajevo. Patients were divided according to the treatment method in a group of patients with open appendectomy and a group of patients treated by laparoscopic and compared with demographic and clinical data and outcomes of treatment.
Results: The average time of anesthesia was 10 minutes longer in the group of patients who received laparoscopic appendectomy compared to the open appendectomy (p = 0.0086). The average length of hospitalization was 2 days shorter in the laparoscopic group of patients (p <0.0001). Laparoscopically operated patients had a shorter application of parenteral analgesia compared to the patients with the open appendectomy (p = 0.0061). In patients with laparoscopic appendectomy the period of drainage was shorter (p <0.0001).
Conclusion: Laparoscopic appendectomy proved to be an effective method and is increasingly represented in the treatment of acute appendicitis of children. Children undergoing laparoscopic treatment are significantly shorter in the hospital, have a lower level of postoperative pain, a shorter period of drainage, however, longer application of anesthesia compared to children who have been operated with an open approach.
Keywords: Appendectomy, laparoscopic, treatment outcome