Effects and clinical outcomes of laparoscopic appendectomy in young children with complicated appendicitis: a case series

Background and purpose
Laparoscopic appendectomy for uncomplicated appendicitis is associated with good outcomes but the role of laparoscopy in complicated appendicitis is more controversial because of high incidence of infectious complications. The aim of this current study is to evaluate the efficacy of laparoscopic appendectomy in complicated appendicitis in young children.
Patients and methods
From May 2015 to May 2016 83 patients aged less than 7 years old underwent laparoscopic appendectomy for complicated acute appendicitis. The following variables were analyzed : age, sex, operative findings, operative time, return of bowel function, resumption of oral feeds, length of hospital stay, postoperative complications (ileus, wound infection and intraabdominal abscess).
Results
The mean age of studied cases was 6.3 years. In 81 patients (97.6%) the procedure was completed laparoscopically. Two (2.4%) patients required conversion to open appendectomy. The operative time was 75.5±28.8 minutes. Two patients (4.6%) had post-operative ileus. One patient (1.2%) developed superficial wound infection. Four patients (4.8%) developed intra-abdominal collections. The mean length of hospital stay was 5.3±2.1 days. No mortality was recorded.
Conclusion
Laparoscopic appendectomy can be the first choice for cases of complicated appendicitis in children. It is a feasible, safe procedure and is associated with acceptable post-operative morbidity with rapid recovery and better cosmetic results.