Risk factors for morbidities in laparoscopic appendectomy for acute appendicitis of paediatric patients

Abstract

Aim: Laparoscopic appendectomy has been the treatment of choice for acute appendicitis in children for many years. The aim of the present study was to analyze factors that are associated with morbidities of this operation and make recommendations to the management protocol. Methods: This is a single-centre study and the study period lasted from January 2002 to June 2007. The medical records of all paediatric patients undergoing emergency laparoscopic appendectomy were reviewed retrospectively. Demographic data, symptoms on presentation, operative findings, duration of operation and antibiotics used were noted. The outcome measures included conversion rate, early and late complication rates as well as duration of total hospital stay. Statistical analysis was done by SPSS version 15.0. Results: A total of 61 emergency laparoscopic appendectomies were carried out during the study period. About two-thirds of the patients were male. Thirty-nine patients were aged 13-18 years. The most common presenting symptoms were lower abdominal pain (83.6%) and fever (95.1%). The overall complication rate was 32.8%. After statistical analysis, late presentation (onset of symptoms for more than 3days) and appendicitis with perforation were found to be risk factors for perioperative morbidities. Conclusion: Late presentation and perforated appendicitis were associated with high complication rates in emergency laparoscopic appendectomy. Parents of the patients should be informed about this before operation. The possibility of using alternative management in these situations can be considered. © Journal compilation © 2009 College of Surgeons of Hong Kong.