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Two-trocar appendectomy in children - Description of technique and comparison with conventional laparoscopic appendectomy

Salö, Martin LU ; Järbur, Emil; Hambraeus, Mette LU ; Ohlsson, Bodil LU ; Stenström, Pernilla LU and Arnbjörnsson, Einar LU (2016) In BMC Surgery 16(1).
Abstract

Background: The aim of the study was to describe the technique of two-trocar laparoscopic appendectomy and compare the outcome between two- and three-trocar techniques in children. Methods: All children who underwent laparoscopic surgery for suspected appendicitis from 2006 to 2014 in a center for pediatric surgery were included in the study. Converted surgeries and patients with appendiceal abscess or concomitant intestinal obstruction were excluded. A total of 259 children underwent appendectomy with either two (35 %) or three (65 %) laparoscopic trocars according to the surgeons' preference and intraoperative judgment. Patient demographics, clinical symptoms, surgery characteristics, and complications were reviewed. Results: The mean... (More)

Background: The aim of the study was to describe the technique of two-trocar laparoscopic appendectomy and compare the outcome between two- and three-trocar techniques in children. Methods: All children who underwent laparoscopic surgery for suspected appendicitis from 2006 to 2014 in a center for pediatric surgery were included in the study. Converted surgeries and patients with appendiceal abscess or concomitant intestinal obstruction were excluded. A total of 259 children underwent appendectomy with either two (35 %) or three (65 %) laparoscopic trocars according to the surgeons' preference and intraoperative judgment. Patient demographics, clinical symptoms, surgery characteristics, and complications were reviewed. Results: The mean age of the children was 10.4 years (range, 1-14 years). The mean follow-up time was 41.2 months (SD ± 29.2). No significant differences in age, gender, weight, or signs and symptoms were found between the two- and three-trocar groups. The mean surgery time was significantly shorter in the two-trocar group (47 min) than in the three-trocar group (66 min; p < 0.001). The rates of surgical complications were 2 % vs. 4 %, (p = 0.501), and the rates of postoperative complications were 0 % vs. 5 % (p = 0.054), in the two- and three-trocar groups. The overall incidence of postoperative wound infection was low (<1 %) and did not differ between groups. Conclusions: Two-trocar laparoscopic appendectomy seems to be a safe and feasible technique with a low rate of postoperative wound infections. The present findings demonstrate that when the two-trocar technique could be applied, it is a good complement to the conventional three-trocar technique.

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author
organization
publishing date
type
Contribution to journal
publication status
published
keywords
Acute abdomen, Appendectomy, Appendicitis, Children, Laparoscopy
in
BMC Surgery
volume
16
issue
1
publisher
BioMed Central
external identifiers
  • Scopus:84982721180
ISSN
1471-2482
DOI
10.1186/s12893-016-0170-1
language
English
LU publication?
yes
id
9ddc048e-72dd-4ef2-9b04-9f1ca9dade15
date added to LUP
2016-09-20 14:15:06
date last changed
2016-09-21 03:00:05
@misc{9ddc048e-72dd-4ef2-9b04-9f1ca9dade15,
  abstract     = {<p>Background: The aim of the study was to describe the technique of two-trocar laparoscopic appendectomy and compare the outcome between two- and three-trocar techniques in children. Methods: All children who underwent laparoscopic surgery for suspected appendicitis from 2006 to 2014 in a center for pediatric surgery were included in the study. Converted surgeries and patients with appendiceal abscess or concomitant intestinal obstruction were excluded. A total of 259 children underwent appendectomy with either two (35 %) or three (65 %) laparoscopic trocars according to the surgeons' preference and intraoperative judgment. Patient demographics, clinical symptoms, surgery characteristics, and complications were reviewed. Results: The mean age of the children was 10.4 years (range, 1-14 years). The mean follow-up time was 41.2 months (SD ± 29.2). No significant differences in age, gender, weight, or signs and symptoms were found between the two- and three-trocar groups. The mean surgery time was significantly shorter in the two-trocar group (47 min) than in the three-trocar group (66 min; p &lt; 0.001). The rates of surgical complications were 2 % vs. 4 %, (p = 0.501), and the rates of postoperative complications were 0 % vs. 5 % (p = 0.054), in the two- and three-trocar groups. The overall incidence of postoperative wound infection was low (&lt;1 %) and did not differ between groups. Conclusions: Two-trocar laparoscopic appendectomy seems to be a safe and feasible technique with a low rate of postoperative wound infections. The present findings demonstrate that when the two-trocar technique could be applied, it is a good complement to the conventional three-trocar technique.</p>},
  author       = {Salö, Martin and Järbur, Emil and Hambraeus, Mette and Ohlsson, Bodil and Stenström, Pernilla and Arnbjörnsson, Einar},
  issn         = {1471-2482},
  keyword      = {Acute abdomen,Appendectomy,Appendicitis,Children,Laparoscopy},
  language     = {eng},
  month        = {08},
  number       = {1},
  publisher    = {ARRAY(0x9eb2f10)},
  series       = {BMC Surgery},
  title        = {Two-trocar appendectomy in children - Description of technique and comparison with conventional laparoscopic appendectomy},
  url          = {http://dx.doi.org/10.1186/s12893-016-0170-1},
  volume       = {16},
  year         = {2016},
}