Abstract

Objective The aim of the present study was to assess the advantages of laparoscopic appendectomy LA compared with open appendectomy OA in children regarding outcomes operative time length of hospital stay antibiotic use and available variables Background Appendicitis is a common cause of acute abdominal pain in children Surgical removal of the appendix by either OA or LA is the treatment of choice Over last two decades LA has failed to be considered superior over OA in adults and children Methods A retrospective chart review of 1883 pediatric patients 14 years diagnosed with acute appendicitis that underwent LA or OA at King Abdulaziz Medical City Riyadh Results A total of 1883 pediatric patients underwent appendectomy 65 male mean age ten years old OA surgical approach was performed in 1673 88 8 patients with a mean age of 10 2 4 LA was performed in 210 11 2 with a mean age of 10 28 2 5 The rates of complication were 3 2 and 5 7 for OA and LA respectively with no statistically significant difference p-value 0 057 The length of hospital stay was significantly different between OA 3 19 2 3 days and LA 3 81 2 4 days p-value 0 001 The LA approach has a significantly longer operative time of 73 2 25 3 min compared with the OA approach 53 1 24 min p-value 0 001 The LA approach has significantly increased over the study time from 0 use in 1998 to 42 use in 2014 Conclusions The LA and OA approach used in the pediatric population show similar risk for post-appendectomy complications LA is associated with longer operative time which might contribute to the higher cost LA has the same need for antibiotics as OA Our findings show that LA is not superior to OA in children although further studies including randomized controlled trials and meta-analysis are required