LAPAROSCOPIC APPENDECTOMY IN CHILDREN-COMPARISION WITH CONVENTIONAL APPENDECTOMY-

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  • 小児に対する腹腔鏡下虫垂切除術に対する検討

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Abstract

Recent advances in laparoscopic appendectomy are reviewed from the literature. This study was undertaken to compare the results of open versus laparoscopic appendectomy for length of operation, complication(s), length of hospital stay, and recovery time in children. A retrospective review from our hospital was performed for all children treated operatively for complicated appendicitis from April, 1996 through April, 2003. Ninety-two cases were identified. Forty-nine children underwent laparoscopic appendectomy, whereas 43 underwent open appendectomy. Complication(s), length of hospital stay, and recovery time did not differ significantly between the laparoscopic appendectomy and open groups. Mean length of operation was 56.9 minutes for open appendectomy and 70.4 minutes for laparoscopic appendectomy (p<0.05). A prospective intraabdominal abscess (IAA) developed in 3 children. IAA occurred in a child after open appendectomy (2.3%) compared with 2 children after laparoscopic appendectomy (4.1%). These 2 children had their peritoneal cavities jet-irrigated with a large amount of saline. There were no increased complications associated with the laparoscopic technique. Postoperative IAA did not differ significantly between the laparoscopic appendectomy and open groups, but one must consider the method of irrigation, amount of saline and so on. The authors consider laparoscopic appendectomy to be the treatment of choice in patients with acute appendicitis.

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