Acceptable outcome after laparoscopic appendectomy in children

IntroductIon: An increasing proportion of childhood appendicitis is being treated with laparoscopic appendec­ tomy (LA). We wanted to elucidate the outcome of child­ hood appendicitis treated primarily by residents in a univer­ sity hospital. MaterIal and Methods: All children (age < 16 years) with appendectomy treated surgically in our department be­ tween January 2006 and January 2011 were identified ret­ rospectively. Readmission, reoperation or post­operative length of hospital stay (LOS) exceeding five days were con­ sidered non­satisfactory outcomes. results: A total of 390 children had an appendectomy per­ formed. The mean age was 9.8 years, and mortality was 0.0%. The surgeon was a resident in 92% of the cases. A to­ tal of 246 (63.1%) had an LA. The rate of LA increased over the five­year period from 45% to 88% (p = 0.01). The con­ version rate decreased from 28% to 15% (p = 0.02). The me­ dian post­operative LOS was one and three days for simple and complicated appendicitis, respectively. A total of 45 pa­ tients (11.5%) had a complication, 40 patients (10.3%) were readmitted, and 56 patients (14.4%) had a non­satisfactory outcome. Logistic regression found open surgery and com­ plicated appendicitis to be associated with an increased risk of complications (p < 0.01). conclusIon: Increased use of LA did not increase the num­ ber of patients with a non­satisfactory outcome. Residents manage this treatment at a highly professional level. Read­ mission due to pain and discomfort was frequent and more targeted and systematic post­operative analgesic care of our children is called for. FundIng: not relevant. trIal regIstratIon: The study was submitted to Clinical­ Trials.gov (NCT01657565).