Laparascopic Appendectomy for Children with Acute Appendicitis Is Equally Safe and Effective Despite Hospital Type

Introduction: Currently only one-third of children with acute appendicitis undergo laparoscopic appendectomy. The reasons for this are unclear, but may include the perception that laparoscopic surgery may not be as safe or effective at all hospital types. Therefore, we retrospectively reviewed all children treated by one pediatric surgeon at two full-service institutions to determine if outcomes would be different based on hospital type. Methods: All children less than 18 years of age who have undergone appendectomy at our urban university or public hospital since January 1, 2004 were reviewed. Only those with the pathologic diagnosis of acute non-perforated appendicitis and with complete medical records were included in the analysis. Data abstracted included age, gender, duration of symptoms, initial WBC count, length of stay (LOS), and complication rate. Patients were divided into two groups based on the type of hospital where treatment was rendered. Data were analyzed using standard statistical methods and significance was assigned to p-values less than 0.05. Results: There were 44 patients who underwent laparoscopic appendectomy at the public hospital, and 38 at the university hospital. There was no difference in age, gender distribution, duration of symptoms, initial WBC, or infectious complication rate (Table). However, children treated at the public hospital had a median LOS one day longer than those children treated at the university hospital despite being treated by the same surgeon (Table). Conclusions: Children with acute appendicitis can be cared for using laparoscopic appendectomy at a full-service university or public hospital with excellent results. Length of stay at the public hospital may be longer due to social factors prohibiting discharge since the complication rates were no different. Laparoscopic appendectomy may be utilized in children no matter what the hospital type, and should be considered a valid treatment option.

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Program Number: P374

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