Laparoscopic appendectomy: Effectiveness in children with generalized and advanced generalized peritonitis cases
Osman Uzunlu
, İncinur Genişol
Department of Pediatric Surgery, Pamukkale University Faculty of Medicine, Denizli, Türkiye
Abstract
Laparoscopic appendectomy is one of the most common surgical procedures in treating pediatric appendicitis. This study aimed to investigate the efficacy of laparoscopic surgery in cases complicated with advanced generalized peritonitis in the pediatric population. The study retrospectively reviewed 55 cases of children who underwent laparoscopic appendectomies. The cases were classified as uncomplicated, complicated, or advanced generalized peritonitis. Laboratory results, diagnostic algorithms, surgical techniques, and complications were investigated. Twenty-four of the cases were boys and 31 were girls. Mean age was 11.3 ± 3 years. Twenty of the cases (36%) were uncomplicated and 35 (64%) were complicated. Nine of the complicated cases presented advanced generalized peritonitis and were additionally classified as “another special group”. Mean leukocyte count and C-reactive protein levels were measured respectively as 22.49 ± 12 x 109 /L and 120.5 ± 99 mg/L in complicated cases and as 17.06 ± 10 x 109 and 52.37 ± 69 mg/L in uncomplicated cases. All advanced generalized peritonitis cases had presented to the hospital with intestinal obstruction and had diffuse abdominal rigidity on physical exam. None of the cases had any complications in the intraoperative or early postoperative period. Infection complications (namely, intra-abdominal abscesses and surgical site infections) were observed in four cases (7%) in the postoperative period. Mean length of hospital stay was 5.62 ± 2.6 days and 3.95 ± 1 days in complicated and uncomplicated cases, respectively. Mean length of stay in advanced generalized peritonitis cases was 8.33 ± 2 days. It was observed that laparoscopic appendectomy might be the first choice of treatment option in cases complicated with advanced generalized peritonitis.
Keywords: Appendectomy, laparoscopy, child, postoperative complications, complicated appendicitis, advanced generalized appendicitis
Cite this article as: Uzunlu O, Genişol İ. Laparoscopic appendectomy: Effectiveness in children with generalized and advanced generalized peritonitis cases. Turk J Surg 2023; 39 (1): 52-56.
This study was approved by Pamukkale University Non-Invasive Clinical Research Ethics Committee (No: E-60116787- 020-14389, Date: 02.02.2021).
Externally peer-reviewed.
Concept - OU; Desing - OU; Data Collection and/ or Processing - OU, İG; Analysis and/or Interpretation - İG; Literature Search - OU; Writing Manuscript - OU; Critical Reviews - OU.
No conflict of interest was declared by the authors.
The authors declared that this study has received no financial support.