COMPLICATED APPENDICITIS IN CHILDREN - LA PAROSCOPY OR MAC-BURNEY INCISION

Purpose : The aim of this retrospective study was to compare open (Mc Burney incision group MB n = 92) and laparoscopic (group LAP n = 58) a ppendectomy for complicated appendicitis (abscess or peritonitis). Mat erial and method: 150 children, with a mean age of 8.5 years, were ope rated in our department from January 1990 to April 1996. Only children with complicated appendicitis and positive bacteriology of peritoneal fluid were included in this study. All children received parenteral a ntibiotics for an average of 5.3 days. Results : The mean operating ti me was significantly longer in the LAP group (63 vs 43 min p<0.0001). The conversion rate in the LAP group was 12%. The mean hospital stay w as 8.4 days (3-29) without any difference between the 2 groups. There was no significant difference for the complication rate in the 2 group s, except for wound infections which were more frequent in the MB grou p (p = 0.008). Late postoperative complications occurred in 3 cases in the MB group (none in the LAP group) (NS). There were 2 small bowel o bstructions and a wound dehiscence. Conclusion: Laparoscopic appendect omy is a safe procedure for complicated appendicitis in children, but the greatest short-term benefit is cosmetic. Long-term results have to be evaluated, particularly with regards to the long-term complication rate.