Is transumbilical laparoscopic-assisted appendectomy feasible for complicated appendicitis? A single-center experience
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In brief
In brief
This retrospective study of 316 pediatric patients demonstrates that transumbilical laparoscopic-assisted appendectomy (TULAA) is safe and feasible for both uncomplicated and complicated appendicitis, with low conversion rates (3%) and comparable outcomes to conventional laparoscopy. While complicated cases required longer operative times and hospital stays, surgical site infection rates were similar between groups.
Written by the GCMD Library team from the article.
Abstract
Purpose
Transumbilical laparoscopic‐assisted surgery (TULS) mixed benefits of laparoscopic and open surgeries. Transumbilical laparoscopic-assisted appendectomy (TULAA) is a well-known procedure, accepted and currently used by pediatric surgeons for treatment of uncomplicated appendicitis (UA). There is no current agreement in its use for the complicated appendiceal infections (CA). We reported our results using TULAA for both UA and CA.
Methods
We retrospectively collected TULAA performed between April 2017 and April 2022. Appendicitis were classified in UA and CA. We analyzed conversion rate, operative time, length of stay, surgical site infections (SSIs) rate, postoperative intra-abdominal abscess and costs.
Results
Over 5 years, 316 children underwent TULAA. Conversion rate was 3%. Mean age at surgery was 9.36 years (IQR 2–16). Forty-nine appendicitis were CA. Operative time and hospital stay was higher in CA than in UA group (38.33 vs. 60.73 min, p < 0.00001; 4 vs. 7 days, p < 0.00001). SSIs rate showed no statistically significant difference between two groups. Incidence of postoperative intra-abdominal collections was 11% in CA and 1% in UA. TULAA’s cost was 192.07 €.
Conclusion
In our series, TULAA seems to be safe, feasible and cost-effective for both uncomplicated and complicated appendicitis, with no disadvantage in terms of outcomes compared to what is reported in literature for CLS.