Acceptable outcome after laparoscopic appendectomy in children
2013
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).
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