Laparoscopic versus open appendectomy for acute appendicitis in children

To compare the efficacy and safety of laparoscopic appendectomy and open appendectomy for acute appendicitis in children. This study was conducted as a retrospective comparison of hospital records for postoperative complications, duration of operation, and postoperative length of stay between children (aged < 18y) who underwent laparoscopic (n=190) or open (n=199) appendectomy over a six-year period. Quality of life was evaluated immediately and 1 month postoperatively. The major complication rate after surgery in laparoscopic group was significantly lower than that of open appendectomy group (13% vs 27%, P < 0.05). The mean (SD) postoperative hospital stay was also shorter in laparoscopic group (2.4 (0.6) days vs 3.7 (1.1) days, P < 0.05). The postoperative minor complication rate and hospital expenses were not significantly different between the two groups. The duration of surgery was longer in laparoscopic group (P < 0.05). Children in laparoscopic group had less postoperative pain and higher quality of life after one month than those in open appendectomy group. Laparoscopic technique seems to be safer than open appendectomy for acute appendicitis in children.