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KMID : 0371319950480060844
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Journal of the Korean Surgical Society
1995 Volume.48 No. 6 p.844 ~ p.852
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The Value of Lkparoscopic appendectomy in Children
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박선무
양대현/암승익/유병욱
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Abstract
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Recently, laparoscopic techniques have been applied to a variety of abdominal procedures that were performed traditionally via an conventional technique.
Although laparoscopic appendectomies are currently in vogue in general surgery, the role of this approach in children has not been evaluated in Korea.
To assess the value of laparoscopic appendectomy(L.A.'s ) for acute appendicitis in children, we compared 37 laparoscopic appendectiomies(L.A.'s) with 97 conventional appendectomies(C.A.'s) from September 1992 to September 1994 in Kang Nam
General
Hospital.
@ES The results were as follows:
@EN 1) The 2 groups were not different significantly with regard to age, but different with regard to sex ratios
The mean ages were 12.0 years in L.A. group and 11.6 years in C.A.group.
The ratios of male to female were 2.1 : 1 in L.A. group and 1.1 : 1 in C.A group.
2) The pathologic severity was not different between 2 groups.
The cases of complicated appendicitis were 38% in L.A. group and 37% in C.A. group.
3) the mean operation time was longer in L.A. group.
The mean operation times were 75.9 minutes in L.A. group and 67.8 minutes in C.A. group(p>0.05).
4) The mean hospital stays were shorter in L.A. group.
The mean hospital stays were 4.2 days in L.A group and 7.0 days in C.A. group(p<0.01).
5) The mean periods of return to normal activity were shorter in L.A. group.
The mean postoperative periods for normal activity were 5.2 days in L.A. group and 10.0 days in C.A. group(p<0.01).
6) the postoperative wound complications were 1 case(2.7%) in L.A. group but 12 cases(12.3%) in C.A. group.
7) The use of postoperative analgesics was less frequent in L.A. group.
The postoperative analgesics were used in 4 cases(10.8%) in L.A. group and 28 cases(28.9%) in C.A. group.
8) the postoperative readmission or reoperation was none in L.A. group but readmission was needed in 2 cases of C.A. group.
We have not converted a laparoscopeic appendectomy to a conventional appendectomy.
Patients who underwent laparoscopic appendectomies have a shorter duration of hospital stay, a lesser pain and scarring, and return to normal activities sooner postoperatively when compared wit patients who underwent conventional appendectomies.
Self-limiting complications related to laparoscopic appendectomy were experienced such as a scrotal swelling and an edema at trocar puncture site.
We believe that this procedure is a safe and feasible procedure when be done by the experienced surgeons familiar with laparoscopic procedures.
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