小児穿孔性虫垂炎に対する開腹手術と比した腹腔鏡手術の有用性の検討

【Background】
The role of laparoscopy in the management of perforated appendicitis in children is still somewhat controversial. We evaluated outcomes between open and laparoscopic surgery for perforated appendicitis in children.
【Patients and methods】
The medical records which underwent appendectomy for perforated appendicitis in children less than 15 years old from April 2003 to March 2015 were retrospectively reviewed.
【Results】
A total of 78 patients were enrolled. Twenty-five children underwent open appendectomy（OA）and 53 had laparoscopic appendectomy（LA） for perforated appendicitis. The mean operative time for LA（80.4±40.2 minutes for OA vs 109.0±29.7 minutes for LA, p＜0.01）was significantly longer. Patients in the LA group returned to oral intake earlier（2.3±1.1 days for LA vs 3.6±1.7 days for OA, p＜0.01）and had a shorter length of hospital stay（8.5±4.9 days for LA vs 12.7±6.3 days for OA, p＜0.01）. The incidence of postoperative complication in LA group was lower（6 cases for LA vs 8 cases for OA, p＜0.05）.
【Conclusions】
Laparoscopic appendectomy for perforated appendicitis in children was a feasible procedure which effects early postoperative oral intake, shortened length of hospital stay, and reducepostoperative complications.