scholarly journals Efficacy and Safety of Laparoscopic Appendectomy for Complicated Appendicitis in Children in Tertiary Care Hospital

2018 ◽  
Vol 28 (Number 1) ◽  
pp. 21-26
Author(s):  
Md. Anisuzzaman ◽  
ASM A Kabir ◽  
Md. A R l Sadiq ◽  
Md. A Matin ◽  
I Ahmed ◽  
...  

Laparoscopic appendectomy for uncomplicated appendicitis is associated with good outcomes but the role of laparoscopy in complicated appendicitis is more controversial because of high incidence of infectious complications. The aim of this current study is to evaluate the efficacy and safety of laparoscopic appendectomy in complicated appendicitis in children. This interventional study was carried out during the period from January 2015 to May 2018 in Holy Family Red Crescent Medical College Hospital. The study included 43 patients, age ranges from 3 years to 15 years who underwent laparoscopic appendectomy for complicated acute appendicitis. The following variables were analyzed : age, sex, operative findings, operative time, return of bowel function, resumption of oral feeds, length of hospital stay, postoperative complications such as deur, wound infection and intraabdominal abscess etc. The mean age of studied cases was 7.1 years. In 41 patients (95.3%) the procedure was completed laparoscopically. Two (4.7%) patients required conversion to open appendectomy. The operative time was 83.5+,25.8 minutes. Two patients (4.6%) had post-operative ileus. Four patients (9.7%) developed superficial wound infection. Three patients (7.3%) developed infra-abdominal collections. One (2.4%) patients were readmitted because of recurrent abdominal pain One patients (2.4%) developed postoperative pyrexia due to pneumonitis and Three patients (7.3) developed gastroenteritis. The mean length of hospital stay was 5.8±2.1 days. No mortality was recorded.Laparoscopic appendectomy can be the first choice for cases of complicated appendicitis in children. It is a feasible, safe procedure and is associated with acceptable post-operative morbidity with rapid recovery and better cosmetic results.

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Md. Jafrul Hannan

Background. Since the latter half of 1980s laparoscopy has become a well accepted modality in children in many surgical procedures including appendectomy. We present here the experience of laparoscopic appendectomy in children in a tertiary care hospital in Bangladesh.  Subjects & Methods. From October 7, 2005 to July 31, 2012, 1809 laparoscopic appendectomies were performed. Laparoscopy was performed in all the cases using 3 ports. For difficult and adherent cases submucosal appendectomy was performed. Feeding was allowed 6 h after surgery and the majority was discharged on the first postoperative day. The age, sex, operative techniques, operative findings, operative time, hospital stay, outcome, and complications were evaluated in this retrospective study.Results. Mean age was 8.17 ± 3.28 years and 69% were males. Fifteen percent were complicated appendicitis, 8 cases needed conversion, and 27 cases were done by submucosal technique. Mean operating time was 39.8 ± 14.2 minutes and mean postoperative hospital stay was 1.91 days. About 5% cases had postoperative complications including 4 intra-abdominal abscesses.Conclusions. Laparoscopic appendectomy is a safe procedure in children even in complicated cases.


Author(s):  
PEDRO HENRIQUE CUNHA LEITE ◽  
ALESSANDRO WASUM MARIANI ◽  
PEDRO HENRIQUE XAVIER NABUCO DE ARAUJO ◽  
CARLOS EDUARDO TEIXEIRA LIMA ◽  
FELIPE BRAGA ◽  
...  

ABSTRACT Objective: in Latin America, especially Brazil, the use of a robotic platform for thoracic surgery is gradually increasing in recent years. However, despite tuberculosis and inflammatory pulmonary diseases are endemic in our country, there is a lack of studies describing the results of robotic surgical treatment of bronchiectasis. This study aims to evaluate the surgical outcomes of robotic surgery for inflammatory and infective diseases by determining the extent of resection, postoperative complications, operative time, and length of hospital stay. Methods: retrospective study from a database involving patients diagnosed with bronchiectasis and undergoing robotic thoracic surgery at three hospitals in Brazil between January of 2017 and January of 2020. Results: a total of 7 patients were included. The mean age was 47 + 18.3 years (range, 18-70 years). Most patients had non-cystic fibrosis bronchiectasis (n=5), followed by tuberculosis bronchiectasis (n=1) and lung abscess (n=1). The performed surgeries were lobectomy (n=3), anatomic segmentectomy (n=3), and bilobectomy (n=1). The median console time was 147 minutes (range 61-288 min.) and there was no need for conversion to open thoracotomy. There were no major complications. Postoperative complications occurred in one patient and it was a case of constipation with the need for an intestinal lavage. The median for chest tube time and hospital stay, in days, was 1 (range, 1-6 days) and 5 (range, 2-14 days) respectively. Conclusions: robotic thoracic surgery for inflammatory and infective diseases is a feasible and safe procedure, with a low risk of complications and morbidity.


2001 ◽  
Vol 7 (4-5) ◽  
pp. 838-840
Author(s):  
A. Al Raymoony

This study was conducted on 100 patients with symptomatic gallbladder stones, aged 22-81 years with a mean of 51.5 years, who underwent cholecystectomy in Zarqa city, Jordan between July 1998 and July 1999. The success rate was 87% and the procedure was completed using the conventional method in 13 patients. The mean operative time was 60 minutes, complication rate was 5% and there were no deaths. The mean hospital stay was 1 day and mean time to return to work was 10 days. This study showed that laparoscopic cholecystectomy is a safe procedure with reasonable operative time, less postoperative pain, a short hospital stay, early return to work, and a low morbidity and mortality rate.


Author(s):  
Sahun .

Aims: To study the advantages and disadvantages of laparoscopic truncal vagotomy and gastrojejunostomy, the outcome of surgery in terms of – mean operative time, Conversion rate, Postoperative pain measurement, intraoperative and postoperative complication and duration of hospital stay. Methods: A prospective analysis of operative, postoperative and short term outcome of 21 patients were carried out during time period of 2016 to 2019. Results: Out of 21 patient,.64% patients were males and 36 % patients were females. Male to female ratio was 1.7: 1. The mean operative time required was 130 minutes and the mean pain scale measured was 3 ± 0.81 on second day .The incidence of intraoperative and early postoperative complication was 5.26 % and 10.52 % respectively. The mean length of hospital stay was 8 days. Average follow up duration was 12 months. Conclusion: It is viable and safe option with shorter operative time and length of stay. It can be performed successfully with minimal morbidity and no mortality. However extreme care and skill is required to identify anatomy and handling of stapler. Keywords: Laparoscopy; Stapler Gastrojejunostomy; Vagotomy; Endoscopy.


2021 ◽  
Vol 13 (2) ◽  
Author(s):  
Andrej Nikolovski ◽  
Aleksandar Otljanski ◽  
Rexhep Seljmani ◽  
Svetozar Antovic ◽  
Nikola Jankulovski

Laparoscopic appendectomy is the preferred operative method for acute appendicitistreatment. In terms of complicated appendicitis it can be effective in hands of an experiencedlaparoscopist that overwhelmed the learning curve for the method. Aim: Тhis retrospectivestudy examines whether the operative time for laparoscopic appendectomy for complicatedappendicitis is shortened after mastering the learning curve. Material and methods: A totalnumber of 196 patients were operated for the diagnosis of acute appendicitis, of whom 77were diagnosed with complicated appendicitis. They were subsequently divided in two groups(laparoscopic and open). Operative time in both groups was measured and the conversionand postoperative complications were noted. Results: Conversion rate was 2.3%. Operativetime was shorter in the laparoscopic group (67.4 ± 22.9 vs. 77.9 ± 17.9 minutes; p = 0.033).Overall postoperative morbidity was 25.97% with wound infection present only in the opengroup (p = 0.018). Intraabdominal abscess occurred in one patient from the laparoscopicgroup (0.38%). Length of hospital stay was shorter in the laparoscopic group (4.3 ± 2.2 vs. 5.7 ± 2.1, p = 0.0052).  


2017 ◽  
Vol 24 (01) ◽  
pp. 82-88
Author(s):  
Awais Shuja ◽  
Professor M Ramzan ◽  
Nadia Sharif

Appendectomy is the most common surgical procedure performed in surgicalemergency. The advent of minimal invasive surgery has massively influenced the field of surgery.Laparoscopic surgery might offer clinical benefits in perforated and complicated appendicitis.Objective: To compare laparoscopic appendectomy and open appendectomy as treatment ofcomplicated appendicitis in terms of mean requirement of post-operative analgesia, operativetime and hospital stay. Study design: Randomized control trial. Setting: All subjects for thestudy were recruited from Department of Surgery, Independent University Hospital, Faisalabad.Duration: The duration of study was of 6 months duration from February 2012 to august 2012.Results: In this study the divided into two groups, group A for open appendectomy (OA)and group B for Laparoscopic Appendectomy (LA). Both groups had 43 patients each. Theoperating time for open appendectomy group A had mean operating time 37.21 minutes .Thehospital stay in OA group was 2.63 days. The mean dosage of analgesia requirement was 258mg of diclofenac. The operating time for open appendectomy group A had mean operatingtime 39.16 minutes. The hospital stay in OA group was 2.95 days. The mean dosage of was258.14 mg of diclofenac. Conclusion: Our study concludes that both approaches laparoscopicand open approach have proved to be similar in terms of post-operative hospital stay, operatingtime and analgesia requirement. Where as LA is superior in terms of cosmesis and surgicalsite infection. Further studies with more number of patients are recommended to asscess thebenefits of laparoscopic approach in complicated appendicitis.


2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Cetin Ali Karadag ◽  
Basak Erginel ◽  
Ozgur Kuzdan ◽  
Nihat Sever ◽  
Melih Akın ◽  
...  

Background. The aim of our study is to compare the efficacy of laparoscopic splenectomy (LS) between enlarged spleens and normal sized spleens.Methods. From June 2006 to September 2012, 50 patients underwent LS. The patients consisted of 24 girls and 26 boys with the mean age of 8.64 years (1–18). The patients are divided into two groups according to spleen’s longitudinal length on the ultrasonography. Group I consisted of the normal sized spleens; Group II consisted of spleens that are exceeding the upper limit. Groups are compared in terms of number of ports, operative time, rate of conversion to open procedure, and length of hospital stay.Results. The mean number of ports was 3.27 and 3.46, the mean length of the operation was 116.36 min and 132.17 min, rate of conversion to open procedure was 9.09% and 10.25%, and the mean length of hospital stay was 3.36 days and 3.23 days, respectively, in Group I and Group II. Although there is an increase in the number of the ports, the operative time, rate of conversion to open procedure, and the length of hospital stay, the difference was not significant between groups (P>0.05).Conclusion. LS is safe and effective in enlarged spleens as well as normal sized spleens.


2016 ◽  
Vol 18 (3) ◽  
pp. 22 ◽  
Author(s):  
R Poudel

Background: Acute Appendicitis is the most common general surgical emergency. Despite improved asepsis and surgical techniques, postoperative complications are still common. The general assumption is that it is better to treat patients with complicated appendicitis (perforated or gangrenous) with antibiotics, in contrast to patients with simple appendicitis. Aim of this study was to compare outcomes of patients treated with antibiotics after appendectomy in complicated appendicitis with those of patients who were not treated with antibiotics.Methods: This was a retrospective study carried out in Universal College of Medical Sciences, Bhairawha, Nepal. Patients who underwent emergency appendectomy in 2 years period were included in the study. Patients with complicated appendicitis were analyzed on the basis of whether they received postoperative antibiotics or not. Main outcome measured were wound complications and length of hospital stay.Results: During the 2-year study period, a total of 203 patients met inclusion criteria. Complicated appendicitis was identified in 71 patients (34.97%). Postoperative antibiotics were administered to 42 (59.2%). On Univariate and multivariate analyses Postoperative antibiotics were not associated with decrease in wound infection. But it is associated with increase in length of hospital stay (p <0.01, 95% confidence interval 2.68-6.05).Conclusion: Use of Postoperative antibiotics does not decrease the rate of wound infection in patient with complicated appendicitis but result in increase length of hospital stay.


2020 ◽  
Vol 19 (1-2) ◽  
pp. 34-41
Author(s):  
Andrej Nikolovski ◽  
Shenol Tahir ◽  
Dragoslav Mladenovikj

Background. Laparoscopic appendectomy is established method in the treatment of complicated appendicitis. Certain advantages of the technique do not fulfill the expectations for its superiority over the open appendectomy as when it is used for uncomplicated appendicitis. This is generally caused because of the high variety of postoperative complications reported in different series for complicated appendicitis. Material and methods. This prospective interventional clinical study analyzes 61 patients operated with laparoscopic and open appendectomy due to complicated appendicitis, with an end point of comparing the intra and postoperative complications in both groups. Results. Conversion in open appendectomy was forced in one patient (1.63%). The operative time was significantly shorter in the laparoscopic group (p = 0.048). Wound infection was significantly predominant in the open group (p = 0.045). Postoperative intraabdominal abscess occurred in one patient in the laparoscopic group (p = 0.52). The overall morbidity was 26.2% (7 patients in the laparoscopic, and 9 in the open group; p = 0.59). Length of stay was significantly shorter in the laparoscopic group (p = 0.00001). Conclusion. Certain significant advantages of the laparoscopic appendectomy as low incidence of wound infection, short hospitalization, less postoperative pain and faster socialization makes the laparoscopy up to date method in the treatment of complicated appendicitis.


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