WOFAPS 2025 8th World Congress of Pediatric Surgery

Esther Saguil, Daniel Ernest Florendo

Philippine General Hospital

BACKGROUND. Laparoscopic appendectomy is now commonplace and the preferred approach in many first world countries; however , many developing countries still manage the condition through open surgery. In order to improve the acceptance and viabiltity of laparsocopic appendectomy , we decided to promote the approach in pediatric patients to determine the advantages and potential problems with MIS adoption. Surgical outcomes , including duration and complications from laparoscopic and open procedures are compared.

METHODOLOGY. This retrospective cohort analysis encompasses all pediatric appendicitis cases at our institution from 2022 to 2023. There were a total of 273 cases during that period. Patient records were reviewed for surgical approach and outcomes.

RESULTS. The mean patient age was 11.87 years with a male: female ratio of 1.84. Average duration of symptoms prior to consult was 2.47 days. Most of the patients had complicated appendicitis (57.8% ruptured, 10.2% gangrenous). For the surgical approach, 42.9% underwent open appendectomy (OA) and 57.1% had LA with a conversion rate of 7.14%. Irrespective of disease severity, LA was superior to OA in terms of time to resume feeding (2.84 vs 4.07 days), post-op length of stay (5.29 vs 6.95 days), and surgical site infection rate (3.3% vs 16.2%). Operative times were not statistically different, Other morbidities for LA included intraabdominal abscess (1.9%) and postoperative adhesions requiring adhesiolysis (1.3%), while the OA group reported 1 case each for adhesions, intraabdominal abscess, and incisional hernia.

CONCLUSION. This study highlights the superiority of laparoscopic appendectomy in the pediatric population as implemented in a referral center. It also provides preliminary data on a significant cohort of patients with complicated appendicitis who underwent laparoscopic management . Further studies on cost benefit analysis should be undertaken to improve the adoption of the laaproscopic approach. Earlier consultation should also be highlighted to minimize complications .