Treatment of Acute Appendicitis in Children : the Usefulness of Laparoscopic Immediate Appendectomy and Interval Appendectomy

FUJINO Junko, SUZUKI Makoto, HASEGAWA Mariko, IGARASHI Akihiro, HATANAKA Masahiro, ISHIMARU Yuki, IKEDA Hitoshi

doi:10.3919/jjsa.74.2051

A retrospective analysis was performed to evaluate the usefulness of laparoscopic immediate appendectomy (IMA) and interval appendectomy (IA) in children with acute appendicitis. There were 510 children diagnosed as having acute appendicitis and 485 patients (95.1%) of them were treated by IMA. Laparoscopic IMA was performed in 420 (86.6%) of these 485 patients, and conversion to conventional open surgery was necessary in three patients. The incidences of surgical complications were 4.0% in patients with uncomplicated appendicitis and 19.3% in those with complicated appendicitis. Laparoscopy-related complications were observed in the early days after the introduction of laparoscopic appendectomy. On the other hand, IA was performed in 25 (4.9%) out of 510 patients. Although abdominal pain recurred during the interval waiting IA, nonoperative treatments were successful and delayed laparoscopic appendectomy was performed in all these patients. The final diagnoses included carcinoid tumor of the appendix and Meckel's diverticulitis in one patient, respectively. There were no surgical complications except intraoperative minor injuries of the intestinal serosa. We conclude that laparoscopic appendectomy is a standard option of IMA in children with acute appendicitis and nonoperative treatment followed by IA is effective in evading major surgical complications caused by IMA in children with appendiceal mass or abscess.

Treatment of Acute Appendicitis in Children : the Usefulness of Laparoscopic Immediate Appendectomy and Interval Appendectomy

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