Objective:

To compare the safety and feasibility of transumbilical laparoscopic-assisted appendectomy (TULAA) vs. three-port laparoscopic appendectomy (TPLA) for pediatric acute appendicitis.

Key Findings:

• No significant differences in baseline characteristics between TULAA and TPLA groups.
• Mean operative time was comparable: TULAA (54.94 min) vs. TPLA (58.65 min).
• TULAA group had a shorter average hospital stay (4.83 days) compared to TPLA (5.35 days).
• Time to first postoperative flatus was longer in TULAA (25.81 h) than TPLA (21.13 h).
• Overall complication rates were similar: TULAA (4.6%) vs. TPLA (6.5%).

Interpretation:

TULAA is a safe and feasible minimally invasive technique for pediatric appendicitis, offering a shorter hospital stay despite a delayed return of bowel function compared to TPLA.

Limitations:

• Retrospective design may introduce selection bias.
• Single-center study limits generalizability.

Conclusion:

TULAA is a valuable surgical option for pediatric acute appendicitis, demonstrating comparable outcomes to TPLA with the added benefit of reduced hospital stay.