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Development in the Surgical Treatment of Acute Appendicitis: A Single-center Experience

PURPOSE: Laparoscopy has become the treatment of choice for acute appendicitis. The aim of the study was to compare open (OA) and laparoscopic (LA) approaches in all forms of acute appendicitis. METHODOLOGY: Two hundred and ninety-two children underwent appendectomy (238 LA/54 OA). 3/238 patients re...

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Autores principales: Pastore, Valentina, Cocomazzi, Raffaella, Basile, Angela, Niglio, Francesco, Bartoli, Fabio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7818663/
https://www.ncbi.nlm.nih.gov/pubmed/33106445
http://dx.doi.org/10.4103/ajps.AJPS_77_17
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author Pastore, Valentina
Cocomazzi, Raffaella
Basile, Angela
Niglio, Francesco
Bartoli, Fabio
author_facet Pastore, Valentina
Cocomazzi, Raffaella
Basile, Angela
Niglio, Francesco
Bartoli, Fabio
author_sort Pastore, Valentina
collection PubMed
description PURPOSE: Laparoscopy has become the treatment of choice for acute appendicitis. The aim of the study was to compare open (OA) and laparoscopic (LA) approaches in all forms of acute appendicitis. METHODOLOGY: Two hundred and ninety-two children underwent appendectomy (238 LA/54 OA). 3/238 patients required conversion. LA surgical technique has been modified by closing also the distal stump of appendix (DSC) before removing it. RESULTS: Early experience: 130 appendectomy, 44 by OA (34%), and 86 by LA (66%). The mean operative time was similar for both techniques. Complicated appendicitis (CA) was observed in 14 patients (11%). 10 patients treated with OA (10/14 = 71%) and 4 with LA (4/14 = 29%). Complications occurred mainly in the LA group without statistical significance. LATE EXPERIENCE: One hundred and sixty-two appendectomy, 10 OA (6.17%), and 152 LA (93.8%). Thirty-eight children (23.4%) had CA. The mean operative time was lower in LA group without reaching statistical significance. Total complication rate (CR) was 7.4%. CR in patients with DSC was null and significantly lower when compared to patients without DSC. CONCLUSION: Our results demonstrated that nearly all cases of appendicitis may be managed by laparoscopy. Ligature of distal appendiceal stump is a trick that may significantly improve outcomes during LA appendectomy.
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spelling pubmed-78186632021-01-22 Development in the Surgical Treatment of Acute Appendicitis: A Single-center Experience Pastore, Valentina Cocomazzi, Raffaella Basile, Angela Niglio, Francesco Bartoli, Fabio Afr J Paediatr Surg Original Article PURPOSE: Laparoscopy has become the treatment of choice for acute appendicitis. The aim of the study was to compare open (OA) and laparoscopic (LA) approaches in all forms of acute appendicitis. METHODOLOGY: Two hundred and ninety-two children underwent appendectomy (238 LA/54 OA). 3/238 patients required conversion. LA surgical technique has been modified by closing also the distal stump of appendix (DSC) before removing it. RESULTS: Early experience: 130 appendectomy, 44 by OA (34%), and 86 by LA (66%). The mean operative time was similar for both techniques. Complicated appendicitis (CA) was observed in 14 patients (11%). 10 patients treated with OA (10/14 = 71%) and 4 with LA (4/14 = 29%). Complications occurred mainly in the LA group without statistical significance. LATE EXPERIENCE: One hundred and sixty-two appendectomy, 10 OA (6.17%), and 152 LA (93.8%). Thirty-eight children (23.4%) had CA. The mean operative time was lower in LA group without reaching statistical significance. Total complication rate (CR) was 7.4%. CR in patients with DSC was null and significantly lower when compared to patients without DSC. CONCLUSION: Our results demonstrated that nearly all cases of appendicitis may be managed by laparoscopy. Ligature of distal appendiceal stump is a trick that may significantly improve outcomes during LA appendectomy. Wolters Kluwer - Medknow 2020 2020-10-21 /pmc/articles/PMC7818663/ /pubmed/33106445 http://dx.doi.org/10.4103/ajps.AJPS_77_17 Text en Copyright: © 2020 African Journal of Paediatric Surgery http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Pastore, Valentina
Cocomazzi, Raffaella
Basile, Angela
Niglio, Francesco
Bartoli, Fabio
Development in the Surgical Treatment of Acute Appendicitis: A Single-center Experience
title Development in the Surgical Treatment of Acute Appendicitis: A Single-center Experience
title_full Development in the Surgical Treatment of Acute Appendicitis: A Single-center Experience
title_fullStr Development in the Surgical Treatment of Acute Appendicitis: A Single-center Experience
title_full_unstemmed Development in the Surgical Treatment of Acute Appendicitis: A Single-center Experience
title_short Development in the Surgical Treatment of Acute Appendicitis: A Single-center Experience
title_sort development in the surgical treatment of acute appendicitis: a single-center experience
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7818663/
https://www.ncbi.nlm.nih.gov/pubmed/33106445
http://dx.doi.org/10.4103/ajps.AJPS_77_17
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