Abstract

Background:  Appendicitis is one of the most common surgical emergency among children .Nearly 30% of children present  to hospital with complicated appendicitis, which is associated with higher morbidity than simple appendicitis. Controversy exists in the treatment of complicated appendicitis in pediatric age group.The goal of this study was to review the results of laparoscopic surgery in complicated appendicitis in terms of safety, efficacy and complications
Methodology-  A Retrospective observational study  was  conducted in a Tertiary care hospital in Bangalore from  2015 to 2020 over a period of 5 years . All children who underwent laparoscopic surgery for  complicated appendicitis (perforated, gangrenous and mass) were included in the study. Thorough history with respect to symptoms and their duration were recorded followed by general and abdominal examination. Routine blood investigation and imaging were done before surgery. Intra operative data regarding the type of complication, presence or absence of  Fecolith, position of appendix were documented. Post operatively duration of stay and complications were analyzed.
Results- 60 cases were included in the study. Mean age of presentation was 10.11 ±0.855 years. Out of 60 children 53 were males and 7 were females. The mean operative time was 55.8333 ±4.806 min. The rate of conversion from the laparoscopy  to open surgery was 11.5%. Mean time of duration of intravenous antibiotics was4.2778 ±0.446 days. Mean time for starting of oral feeding was 2.8333 ±0.307 days. Mean duration  of  hospital stay was 5.11 ±0.545days . Wound infection in immediate post operative period was seen in 6.6% of the children. No long term complications were noted.
Conclusion- Laparoscopic appendectomy (LA) for complicated appendicitis is safe and effective. Therefore, it should  be the first choice for cases of complicated appendicitis in children