Laparoscopic Appendectomy in Children with Complicated Appendicitis: Is It Safe? (Series of 50 Cases)

Background: Acute complicated appendicitis is a common emergency in children. Unlike simple appendicitis, Laparoscopy is not an accepted procedure for complicated appendicitis in children for many pediatric surgeons. This procedure is associated with a more inside of postoperative abdominal abscess reported in some cases. We study the security, efficacy and complications of laparoscopy in children with complicated appendicitis . Methods Between May 2018 and May 2021, 50 children aged 4 to 16 years with complicated appendicitis were treated by laparoscopic appendectomy in all cases at the department of Pediatric Surgery, Faculty of medicine, Tanta university hospital, Egypt Primary outcomes were incidence of complications, intraabdominal abscess and wound infection. Secondary outcomes were length of operation, hospital stay, resumption of diet and incidence of bowel obstruction. Results: LA was performed in 50 children aged 4 to 16 years (mean of 8.3±4.212 year) over a 3-year period. All cases had complicated appendicitis (either localized or generalized peritonitis). There was one conversion to open appendectomy (OA) in a patient with gangrenous perforated base with friable cecum. The Average duration of symptoms was four days (ranged 3-6 days). The mean length of operation was 51.7 ± 18.5 min (ranged 40-80 minutes). The average length of hospital stay was 2.6 days with range of 2-7days. intraabdominal collection was presented in 3 patients(6%), Postoperative ileus in 2 patients (4%), wound seroma in 4 patients (8%), wound infection in 4 patients (8%). The average follow-up was 3 months. Conclusions: Laparoscopic appendectomy is safe, feasible, and effective procedure in the management of complicated appendicitis in children, with no evidence of any increase in the postoperative complications.