Open versus laparoscopic appendectomy for acute appendicitis in children

Česká verze

Authors: R. Štichhauer; J. Koudelka
Authors place of work: Oddělení dětské chirurgie a traumatologie, FN Hradec Králové
Published in the journal: Rozhl. Chir., 2018, roč. 97, č. 3, s. 117-121.
Category: Původní práce

Summary

Introduction:
Acute appendicitis is a common disease affecting both adults and children. The basic therapeutic procedure is an appendectomy. Open appendectomy has been gradually supplemented and sometimes replaced by a laparoscopic approach in numerous departments. The aim of our work was to compare laparoscopic and open surgery objectively.

Method:
Retrospective analysis of data from patients operated on at the Department of Pediatric Surgery and Traumatology, Teaching Hospital in Hradec Králové in 2009−2016. Only the precisely evaluated parameters, i.e. the time of anesthesia, the time of surgery and the duration of post-operative pain, were assessed within the scope of objectification. Data were evaluated only in a homogeneous group of patients with phlegmonous appendicitis.

Results:
During the above period, 261 patients with acute appendicitis were operated on at our department, 166 of whom suffered from phlegmonous appendicitis. 133 children were operated laparoscopically and 33 by open procedure. The results obtained were statistically significantly different only for the time of anesthesia (p=0.00035) which was shorter in open operations. The time of surgery was also shorter in the open operation group, but only at the limit of statistical significance. A statistically significant difference was not found in the time of duration of pain for individual surgical approaches.

Conclusion:
Laparoscopic approach in the surgical treatment of acute appendicitis is a more modern method than open surgery and it has become a standard procedure in some departments. However, the results of our study confirm that the open approach remains an equivalent alternative to the treatment of acute phlegmonous appendicitis.

Key words:
appendicitis − open appendectomy − laparoscopy

Zdroje

1. Štuj J. Akutní apendicitida. In: Šnajdauf J, Škába R, et al. Dětská chirurgie, 1. vyd. Praha, Galén 2005:227−32.

2. Jasonni V. Appendectomy. In: Puri P, Höllwarth M, et al. Pediatric Surgery, 2. vyd. Berlin Springer-Verlag 2006:321−7.

3. Rentea RM, St Peter SD. Pediatric appendicitis. Surg Clin North Am 2017;97: 93−112.

4. Goldberg LC, Prior J, Woolridge D. Appendicitis in the infant population: a case report and review of a four-month old with appendicitis. J Emerg Surg 2016; 50:765–8.

5. Xu J, Adams S, Liu YC, et al. Nonoperative management in children with early acute appendicitis: A systematic review. J Pediatr Surg 2017. Available from: 10.1016/j.pedsurg.2017.05.003 [Epub ahead of print].

6. Huang L, Yin Y, Yang L, et al. Comparison of antibiotic therapy and appendectomy for acute uncomplicated appendicitis in children: A meta-analysis. JAMA Pediatr 2017;171:426−34.

7. López JJ, Deans KJ, Minneci PC. Nonoperative management of appendicitis in children. Curr Opin Paediatr 2017;29:358−62.

8. Caruso AM, Pane A, Garau R, et al. Acute appendicitis in children: not only surgical treatment. J Pediatr Surg 2017;52:444−8.

9. Koivusalo AI, Korpela R, Wirtavuori K, et al. A single-blinded, randomized comparison of laparoscopic versus open hernia repair in children. Pediatrics 2009;123:332−7.

10. St Peter SD, Snyder CL. Operative management of appendicitis. Semin Pediatr Surg 2016;25:208−11.

11. Rintala JR, Pakarinen MP. Appendectomy: open and laparoscopic procedures. In: Spitz L, Coran A at al. Operative Pediatric Surgery, 7th edition, London, CRCPress 2013:478−87.

12. Dai L, Shuai J. Laparoscopic versus open appendectomy in adults and children: A meta-analysis of randomized controlled trials. United European Gastroentrol J 2017;5:542−52.

13. Cheong LH, Emil S. Pediatric laparoscopic appendectomy: a population-based study of trends, associations, and outcomes. J Pediatr Surg 2014;49:1714−8.

14. Li P, Xu Q, Ji Z, et al. Comparison of surgical stress between laparoscopic and open appendectomy in children. J Pediatr Surg 2005;40:1279−83.

15. Lejus C, Delile L, Plattner V, et al. Randomized, single-blinded trial of laparoscopic versus open appendectomy in children: effects on postoperative analgesia. Anestesiology 1996;84:801−6.

16. Lintula H, Kokki H, Vanamo K, et al. The costs and effects of laparoscopic appendectomy in children. Arch Pediatr Adolesc Med 2004;158:34−7.

17. Ure BM, Spangenberger W, Hebebrand D, et al. Laparoscopic surgery in children and adolescents with suspected appendicitis: results of medical technology assessment. Eur J Pediatr Surg, 1992;2:336−40.

18. Bennett J, Boddy A, Rhodes M. Choice of approach for appendicectomy: a meta-analysis of open versus laparoscopic appendicectomy. Surg Laparosc Endosc Percutan Tech 2007;17:245−55.

19. Esposito C, Calvo AI, Castagnetti M, et al. Open versus laparoscopic appendectomy in the pediatric population: a literature review and analysis of complications. J Laparoendosc Adv Surg Tech A 2012;22:834−9.

20. Ikeda H, Ishimaru Y, Takayasu H, et al. Laparoscopic versus open appendectomy in children with uncomplicated and complicated appendicitis. J Pediatr Surg 2004;39:1680−5.

21. Lintula H, Kokki H, Vanamo K. Single-blind randomized clinical trial of laparoscopic versus open appendicectomy in children. Br J Surg 2001;88:510−4.

22. Liu Z, Zhang P, Ma Y, et al. Laparoscopy or not: a meta-analysis of the surgical effects of laparoscopic versus open appendicectomy. Surg Laparosc Endosc Percutan Tech 2010;20:362−70.

23. Adwan H, Weerasuriya CK, Endleman P, et al. Laparoscopic versus open appendicectomy in children: a UK District General Hospital experience. J Pediatr Surg 2014;49:277−9.

24. Nwokoma NJ, Swindells MG, Pahl K, et al. Pediatric advanced appendicitis: open versus laparoscopic approach. Surg Laparosc Endosc Percutan Tech 2009;19:110−3.

25. Markar SR, Blackburn S, Cobb R, et al. Laparoscopic versus open appendectomy for complicated and uncomplicated appendicitis in children. J Gastrointest Surg 2012;16:1993−2004.

26. Serour F, Herman A, Witzling M, et al. Sonographic findings following appendectomy for uncomplicated appendicitis in children. Pediatr Radiol 2009;39:926−32.

27. Gosemann JH, Lange A, Zeidler J, et al. Appendectomy in the pediatric population-a German nationwide cohort analysis. Langenbeck´s Arch Surg 2016;401:651−9.

28. Butter A, Merritt N, Dave S. Establishing a pediatric robotic surgery program in Canada. J Robot Surg 2017;11:207−10.

Štítky

Anesteziologie a resuscitace Dětská chirurgie Dětská urologie Chirurgie cévní Chirurgie hrudní Chirurgie maxilofaciální Chirurgie plastická Chirurgie všeobecná Intenzivní medicína Kardiochirurgie Kardiologie Neurochirurgie Onkologie Ortopedie Popáleninová medicína Protetika Rehabilitační a fyzikální medicína Sestra Traumatologie Urgentní medicína Urologie Student medicíny

Článek Dětská chirurgie v 21. století

Článek Predikce poškození střeva u pacientů s gastroschízou

Článek Multidisciplinární přístup k chirurgickému onemocnění pankreatu v dětském věku

Článek Laparoskopické ošetrenie perforácie čriev po tupom brušnom poranení (BAT) u detí

Článek Suprakondylická zlomenina humeru u dětí

Článek Laparoskopie na pracovišti dětské chirurgie v pětiletém období

Článek Hirschsprungova choroba v dospělém věku − dvě kazuistiky a přehled literatury

Článek 100 let od narození profesora Zdeňka Šerého

Článek vyšel v časopise