Is Mini-Laparoscopic Appendectomy Feasible for Children

Po Li Wei, Ming Te Huang, Tai Chi Chen, Wang Weu, Wei Jei Lee

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Mini-laparoscopic appendectomy (mini-LA) can be performed safely and efficiently. It is the first treatment choice for patients with acute, uncomplicated appendicitis in our hospital. To evaluate the feasibility of mini-LA for simple and ruptured appendicitis in children, we retrospectively compared the outcomes between mini-LA and open appendectomy for appendicitis in children. From October 1998 to August 2000, the medical records of 585 patients with appendicitis were retrospectively reviewed. Children were defined as patients younger than 15 years of age. The percentage of mini-LA, operation time, time to first flatus passage, duration of hospital stay, and demand for intra-muscular pethidine injection were compared between the mini-LA and open appendectomy. The complications among simple and ruptured appendicitis and the cost of mini-LA and open appendectomy were also analyzed. The operation was performed with one infra-umbilical 10-mm incision, and pneumoperitoneum was established at 12 to 15 mm Hg. A 2-mm laparoscope was inserted via the supra-pubic port, and another 2-mm working port was set-up between the other two ports. Statistical testing using the Whitney-Mann U test and Fisher exact test was performed as appropriate. Of the 585 patients, there were 100 children. The youngest patient was 4 years of age and only 7 patients were younger than 5 years. Among children, 18% had a perforated appendix. Mini-LA accounted for 83% of appendectomies in the pediatric group, but it increased yearly (from 41.7% in 1998 to 92.5% in 2000). The operation time of mini-LA and open appendectomy were 57.32 minutes and 49.12 minutes. There was significant improvement in mini-LA from 1998 to 1999. Flatus passage, hospital stay, and pethidine use all favored the mini-LA. For pediatric appendicitis involving a ruptured appendix, postoperative ileus and length of hospital stay were significantly shortened in the mini-LA group. The postoperative complication was not significantly different between mini-LA and open appendicitis. Mini-LA can be safely performed in pediatric patients and it provides early postoperative recovery and short hospital stay. Even for a ruptured appendix, the mini-LA can be the treatment of choice in a well-equipped hospital with well-trained surgeons.

Original languageEnglish
Pages (from-to)61-65
Number of pages5
JournalSurgical Laparoscopy, Endoscopy and Percutaneous Techniques
Volume14
Issue number2
Publication statusPublished - Apr 2004
Externally publishedYes

Fingerprint

Appendectomy
Appendicitis
Length of Stay
Flatulence
Meperidine
Pediatrics
Laparoscopes
Umbilicus
Pneumoperitoneum
Ileus
Nonparametric Statistics
varespladib methyl
Medical Records
Costs and Cost Analysis
Injections
Therapeutics

Keywords

  • Acute appendicitis
  • Children
  • Mini-laparoscopic appendectomy

ASJC Scopus subject areas

  • Surgery

Cite this

Is Mini-Laparoscopic Appendectomy Feasible for Children. / Wei, Po Li; Huang, Ming Te; Chen, Tai Chi; Weu, Wang; Lee, Wei Jei.

In: Surgical Laparoscopy, Endoscopy and Percutaneous Techniques, Vol. 14, No. 2, 04.2004, p. 61-65.

Research output: Contribution to journalArticle

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