Page 27 - World Journal of Laparoscopic Surgery

ORIGINAL ARTICLE
Analyzing the Outcomes of Laparoscopic Appendectomies in

Children: Lessons Learned from 153 Consecutive Surgeries

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Aniket Agrawal , Vivek Viswanathan , Gursev Sandlas , Anoli Agrawal 4
AbstrAct
Introduction and discussion: Appendicitis is one of the most common causes of acute abdomen presenting in the pediatric age-group. Surgical
management is still the gold standard management for this condition. The introduction of the minimally invasive laparoscopic approach
vis‑à‑vis the conventional laparoscopic and open approaches has overhauled the surgical management of this condition. The first laparoscopic
appendectomy was performed by Semm in 1983 in an adult patient; however, it was not until 1992 when the first laparoscopic appendectomy
was done in the pediatric age-group by Ure et al.
Objective: Our goal with this study was to analyze if laparoscopic surgery can be used as the standard of care for appendectomies, regardless
of the type of appendicitis, complicated or uncomplicated.
Results: The results of our study suggest that in the pediatric age-group, males presented with appendicitis more commonly than females.
We also found that the most patients had an average length of stay (ALOS) between 48 and 72 hours, regardless of the type of appendicitis,
complicated or uncomplicated.
Conclusion: This study only reaffirms the fact that a pediatric laparoscopic appendectomy is a safe approach in all types of appendicitis,
complicated or uncomplicated, but it does have a learning curve.
Keywords: Laparoscopic appendectomy, Laparoscopy, Minimally invasive approach, Open and Laparoscopic surgery, Pediatric laparoscopic
surgery.
World Journal of Laparoscopic Surgery (2022): 10.5005/jp-journals-10033-1526

IntroductIon 1,2 Department of Paediatric Surgery, Kokilaben Dhirubhai Ambani
Appendicitis is one of the most common causes for acute abdomen Hospital and Medical Research Institute, Vadodara, Gujarat, India
in the pediatric age-group. Surgical management is still the gold 3 Department of Paediatric Surgery, Topiwala National Medical
standard management for this condition. The introduction of the College and Bai Yamunabai Laxman Nair Charitable Hospital, Mumbai,
minimally invasive laparoscopic approach vis‑à‑vis the conventional Maharashtra, India
laparoscopic and open approaches has overhauled the surgical 4 Department of Public Health Dentistry, JMF’s ACPM Dental College,
management of this condition. Dhule, Mumbai, Maharashtra, India
The first appendectomy was performed over 200 years later Corresponding Author: Vivek Viswanathan, Department of Paediatric
by Claudius Amyand in 1735, whereas the first laparoscopic Surgery, Kokilaben Dhirubhai Ambani Hospital and Medical Research
appendectomy was done over two centuries later in 1983 in adults, Institute, Vadodara, Gujarat, India, Phone: +91 8130156115, e-mail:
and even later in 1992 is when the first pediatric laparoscopic vivek25486@gmail.com
appendectomy was done by Ure et al. However, it was Gilchrist et al. How to cite this article: Agrawal A, Viswanathan V, Sandlas G, et al.
who first presented a paper explaining the benefits of laparoscopic Analyzing the Outcomes of Laparoscopic Appendectomies in Children:
appendectomy over open appendectomy. Lessons Learned from 153 Consecutive Surgeries. World J Lap Surg
Our goal with this study was to look at whether laparoscopic 2022;15(2):123–126.
surgery can be used as the standard of care for any type of Source of support: Nil
appendectomy, complicated or uncomplicated in pediatric patients. Conflict of interest: None

MAterIAls And Methods Exclusion Criteria
We did a retrospective analysis of our prospectively maintained • Any conversion to open procedure
databases of pediatric patients who presented with acute
appendicitis and underwent laparoscopic appendectomy in our
tertiary care center. The data was collected prospectively from results
January 2015 to August 2021. The parameters compared were the Our study aimed to look at three specific parameters, namely, the
age and sex of the patients, the ALOS, and the complications if any. demographic in terms of age and sex distribution for appendicitis
in the pediatric age-group, the ALOS, and complications if any.
Inclusion Criteria
• Diagnosed case of acute appendicitis Demographics (Gender)
• Operated for appendectomy Figure 1 depicts the demographic distribution of the sex of the
• Less than 20 years of age patients who presented with appendicitis at our institution. The

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