Introduction: Acute appendicitis in children is common and the optimal treatment modality is still debated, even if recent data suggest that laparoscopic surgery may result in shorter postoperative length of stay without an increased number of complications. The aim of the study was to compare the outcome of open and laparoscopic appendectomies during a transition period.
Materials And Methods: This was a retrospective cohort study with prospectively collected data. All patients who underwent an operation for suspected appendicitis at the Astrid Lindgren Children's Hospital in Stockholm between 2006 and 2010 were included in the study.
Results: 1745 children were included in this study, of whom 1010 had a laparoscopic intervention. There were no significant differences in the rate of postoperative abscesses, wound infections, readmissions or reoperations between the two groups. The median operating time was longer for laparoscopic appendectomy than for open appendectomy, 51 vs. 37minutes (p<0.05). The postoperative length of stay was similar in the two groups. A simple comparison between the groups suggested that laparoscopic appendectomy had a shorter median postoperative length of stay, 43 vs. 57hours (p<0.05). However, there was a trend in time for a shorter postoperative length of stay, and a trend for more of the procedures to be performed laparoscopically over time so on regression analysis, the apparent decrease in length of stay with laparoscopy could be ascribed to the general trend toward decreased length of stay over time, with no specific additional effect of laparoscopy.
Conclusions: Our data show no difference in outcome between open and laparoscopic surgery for acute appendicitis in children in regard of complications. The initial assumption that the patients treated with laparoscopic surgery had a shorter postoperative stay was not confirmed with linear regression, which showed that the assumed difference was due only to a trend toward shorter postoperative length of stay over time, regardless of the surgical intervention.
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http://dx.doi.org/10.1016/j.jpedsurg.2015.10.002 | DOI Listing |
World J Urol
January 2025
Division of Urology, Department of Surgery, The Hospital for Sick Children, Toronto, ON, Canada.
Objectives: To assess the complication rates associated with split versus intact appendix Mitrofanoff procedures using a single-center retrospective analysis and a systematic review with meta-analysis.
Subjects And Methods: The study comprised a retrospective cohort analysis at a single institution, analyzing patients who underwent a laparoscopic-assisted Mitrofanoff with or without splitting the appendix from 2005 to 2016. The focus was on complications related to both Mitrofanoff and ACE channels.
Objectives: Laparoscopic surgery is widely performed for acute appendicitis. We started conventional 3-port laparoscopic appendectomy (CLA) in 1995 and introduced single-incision laparoscopic appendectomy (SILA) in 2009. This study compared perioperative outcomes between SILA and CLA to evaluate the usefulness of SILA.
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December 2024
Obstetrics and Gynecology, Vassar Brothers Medical Center, Poughkeepsie, USA.
This case reports a 44-year-old female who presented to the gynecologic oncology clinic status post robotic-assisted laparoscopic myomectomy with intraperitoneal unprotected power morcellation in 2012, with an incidental finding of three conglomerate solid masses in the abdomen above the uterus, with each mass measuring approximately 15.5 cm. The patient underwent an exploratory laparotomy where multiple masses greater than 10 cm were found scattered throughout the abdominal cavity.
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December 2024
Surgery, SSM (Sisters of Saint Mary) Health Good Samaritan Hospital, Mount Vernon, USA.
Stump appendicitis is a known post-appendectomy entity causing right lower quadrant abdominal pain. Usually, a patient with a prior history of appendectomy presents to the emergency room with right lower quadrant abdominal pain and stump appendicitis, which is visualized on computed tomography of the abdomen pelvis. We report a case of stump appendicitis diagnosed by colonoscopy and subsequently confirmed by surgery.
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January 2025
Colorectal Surgery, St Mary's Hospital, Isle of Wight NHS Trust, Newport, GBR.
Meckel's diverticulum (MD) is the most common congenital abnormality of the gastrointestinal tract. It usually lies on the antimesenteric side of the ileum, about 60 cm from the ileocecal valve. Histologically, it is a true diverticulum comprising all four layers of the intestinal tract.
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