Transumbilical laparoscopic-assisted appendectomy: a feasible minimally invasive option for pediatric acute appendicitis with comparable outcomes to three-port laparoscopic appendectomy - Report - MDSpire
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Transumbilical laparoscopic-assisted appendectomy: a feasible minimally invasive option for pediatric acute appendicitis with comparable outcomes to three-port laparoscopic appendectomy
Clinical Report: Transumbilical Laparoscopic-Assisted Appendectomy in Pediatrics
Overview
This study compares transumbilical laparoscopic-assisted appendectomy (TULAA) with three-port laparoscopic appendectomy (TPLA) in pediatric patients with acute appendicitis. TULAA demonstrated a significantly shorter hospital stay while maintaining comparable operative times and complication rates.
Background
Acute appendicitis is a common surgical emergency in children, necessitating effective surgical intervention. The shift towards minimally invasive techniques, such as laparoscopic appendectomy, has improved postoperative outcomes. Understanding the efficacy of TULAA compared to traditional methods is crucial for optimizing pediatric surgical care.
Data Highlights
Parameter
TULAA
TPLA
P-value
Operative Time (min)
54.94 ± 24.97
58.65 ± 25.58
0.356
Hospital Stay (days)
4.83 ± 1.53
5.35 ± 1.19
0.022
Time to First Flatus (h)
25.81 ± 11.00
21.13 ± 10.01
0.006
Complication Rate
4.6%
6.5%
0.05
Key Findings
TULAA resulted in a significantly shorter average hospital stay compared to TPLA (4.83 vs. 5.35 days, p = 0.022).
Operative times were comparable between TULAA and TPLA (54.94 vs. 58.65 min, p = 0.356).
Time to first postoperative flatus was significantly longer in the TULAA group (25.81 vs. 21.13 h, p = 0.006).
The overall complication rates were similar between the two groups (TULAA: 4.6% vs. TPLA: 6.5%, p > 0.05).
TULAA is a safe and feasible technique for pediatric acute appendicitis.
Both techniques are effective with no significant differences in baseline characteristics.
Clinical Implications
TULAA may be preferred in pediatric patients due to its association with shorter hospital stays, enhancing recovery and reducing healthcare costs. Clinicians should consider the slightly longer time to bowel function return when discussing surgical options with families.
Conclusion
TULAA is a viable minimally invasive alternative to TPLA for treating pediatric acute appendicitis, offering similar safety profiles and improved postoperative recovery metrics.
