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

BMC Surgery

Research Article

Martin Salö¹  Pernilla Stenström¹  Emil Järbur¹  Mette Hambraeus¹  Einar Arnbjörnsson¹  Bodil Ohlsson² 

[1] Department of Clinical Sciences, Pediatrics, and Department of Pediatric Surgery, Lund University, Skåne University Hospital, Lasarettsgatan 48, 221 85, Lund, Sweden;Department of Clinical Sciences, and Division of Internal Medicine, Lund University, Skåne University Hospital, 205 02, Malmö, Sweden;

关键词: Acute abdomen;    Appendicitis;    Appendectomy;    Children;    Laparoscopy;   

DOI  :  10.1186/s12893-016-0170-1

 received in 2016-03-31, accepted in 2016-07-31,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundThe 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.MethodsAll 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.ResultsThe 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.ConclusionsTwo-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.

【 授权许可】

CC BY   
© The Author(s). 2016