Open versus laparoscopic appendectomy in children: a comparative, prospective study from a tertiary public hospital
DOI:
https://doi.org/10.11606/issn.1679-9836.v100i5p442-448Keywords:
Appendectomy, Appendicitis, General Surgery, Laparoscopy, Pediatrics, Pediatric surgery, Videolaparoscopy, SurgeryAbstract
Introduction: Appendectomy is one of the most performed surgeries in children and it is the therapy of choice for the treatment of acute appendicitis. Current evidence favors appendectomy’s laparoscopic approach over the open one. Objective: The aim of this study is to compare open and laparoscopic appendectomy in the treatment of acute appendicitis in children in a public tertiary hospital in Brazil. Methods: prospective observational study comparing open and laparoscopic appendectomies performed in pediatric patients with acute appendicitis seen between March/2017 and March/2018. Epidemiological, preoperative (clinical, laboratory and imaging exams, time between admission and procedure), intraoperative (procedure time, technique), postoperative (hospitalization time, complications) aspects were analyzed. Results: sample of 63 patients, mean age 8 years. 80.9% had vomiting, Bloomberg sign in 63.5%, and diffuse abdominal pain in 71.4%. Blood count was done in 43 patients, with 72% of leukocytosis and 51.2%, bastonetosis; abdominal radiography in 12 and ultrasonography in 47.6%. 31.7% performed laparoscopic appendectomy, while 68.3% had open appendectomy. There was no difference between the groups regarding cavity conditions and appendix characteristics. The open surgery group had 52,3% complicated appendectomies, 2.3% postoperative complications, and mean hospital stay of 3 days, while in the laparoscopic group, 60% were complicated, 10% with postoperative complications, and average hospital stay of 2.9 days. Conclusion: the present study permits to state, with statistical limitations, that there is no difference between open and videolaparoscopic appendectomy in terms of time between admission and procedure, length of hospital stay, and postoperative complications, with the difference in procedure time being relevant.
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Copyright (c) 2021 Andressa Zabudowski Schroeder, Paula Adamo de Almeida, Gabriela Romaniello, Melina Paula de Araújo Meskau, Bruna Caroline Moreira de Castilho, Leilane de Oliveira, Adria Karina Farias de Aquino, Carolina Marquetto Tognolo, Gustavo Gomes Oliveira, André Ivan Bradley dos Santos Dias, Camila Girardi Fachin
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