TY - JOUR
T1 - Comparison of transumbilical laparoscopic-assisted appendectomy versus single incision laparoscopic appendectomy in children
T2 - which is the better surgical option?
AU - Boo, Yoon Jung
AU - Lee, Yoon
AU - Lee, Ji Sung
N1 - Publisher Copyright:
© 2016 Elsevier Inc.
PY - 2016/8/1
Y1 - 2016/8/1
N2 - Background Transumbilical laparoscopic-assisted appendectomy (TULA) is a single incision technique that exteriorizes the appendix through the umbilicus. The aim of this study was to compare the surgical outcomes of TULA with SILA in pediatric appendicitis. Methods A retrospective review of medical records between April 2011 and April 2015 identified 250 pediatric patients who underwent single incision laparoscopic appendectomy. Of these, 137 patients underwent TULA and 113 patients underwent SILA. Measured outcomes included patients’ demographics, clinical characteristics, operative time, length of stay, pain, and postoperative complications. Results TULA group had a shorter operative time than SILA group (28.93 vs. 49.19 min, p < 0.001). The use of rescue analgesics was more frequent in the SILA group (six cases (6.5%) vs. 19 cases (23.4%), p < 0.001). There was no significant difference in cosmetic outcome between the two groups. However, TULA was associated with a lower complication rate (2/137, 1.5%) than SILA (11/113, 9.8%) (p = 0.0035). In multiple logistic regression analysis, TULA was significantly associated with a lower complication rate (p = 0.049). Conclusions TULA is preferable to SILA for treating pediatric acute appendicitis because it is technically easier, results in better surgical outcomes, and provides the same excellent cosmetic results.
AB - Background Transumbilical laparoscopic-assisted appendectomy (TULA) is a single incision technique that exteriorizes the appendix through the umbilicus. The aim of this study was to compare the surgical outcomes of TULA with SILA in pediatric appendicitis. Methods A retrospective review of medical records between April 2011 and April 2015 identified 250 pediatric patients who underwent single incision laparoscopic appendectomy. Of these, 137 patients underwent TULA and 113 patients underwent SILA. Measured outcomes included patients’ demographics, clinical characteristics, operative time, length of stay, pain, and postoperative complications. Results TULA group had a shorter operative time than SILA group (28.93 vs. 49.19 min, p < 0.001). The use of rescue analgesics was more frequent in the SILA group (six cases (6.5%) vs. 19 cases (23.4%), p < 0.001). There was no significant difference in cosmetic outcome between the two groups. However, TULA was associated with a lower complication rate (2/137, 1.5%) than SILA (11/113, 9.8%) (p = 0.0035). In multiple logistic regression analysis, TULA was significantly associated with a lower complication rate (p = 0.049). Conclusions TULA is preferable to SILA for treating pediatric acute appendicitis because it is technically easier, results in better surgical outcomes, and provides the same excellent cosmetic results.
KW - Appendectomy
KW - Children
KW - Laparoscopy
KW - Single-port access
KW - Transumbilical surgery
UR - http://www.scopus.com/inward/record.url?scp=84956696570&partnerID=8YFLogxK
U2 - 10.1016/j.jpedsurg.2015.12.013
DO - 10.1016/j.jpedsurg.2015.12.013
M3 - Article
C2 - 26850910
AN - SCOPUS:84956696570
SN - 0022-3468
VL - 51
SP - 1288
EP - 1291
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
IS - 8
ER -