WOFAPS 2025 8th World Congress of Pediatric Surgery

Hu Xianchen, Qiu Zhixin, Lin Junshan

The First Affiliated Hospital of Fujian Medical University

Objective

To explore the efficacy and safety of single-port laparoscopy combined with the concept of enhanced recovery after surgery (ERAS) in the treatment of complex appendicitis in children.

Methods

A retrospective analysis was conducted on the clinical data of 76 pediatric patients with complicated appendicitis who underwent inpatient surgical treatment from January 2023 to September 2024. Based on the patients’ clinical symptom and experience of the surgeon, patients were divided into two groups: the single-port laparoscopic group (n=30) and the conventional laparoscopic group (n=46). Both groups followed the ERAS during the perioperative period. The efficacy can be evaluated when compared the series of perioperative indicators in the both two groups of patients.

Results

All 76 children with complicated appendicitis were discharged with full recovery. Compared with the control group, the study group had significantly longer surgical time [(73.19±2.31)vs.(65.46±2.74)min], but less intraoperative blood loss [(3.57±1.68) vs.(5.36±2.34)ml], earlier postoperative feeding [(4.21±1.13)vs.(5.62±3.28)h], shorter time to anal exhaust [(15.05±2.43)vs.(19.31±8.30)h], earlier extubation [(2.52±1.04)vs.(3.32±2.23)d], lower CRP [(20.48±2.11)vs.(21.48±1.83)mg/L], shorter hospital stay [(8.12±1.08)vs.(10.15±1.49)d], and reduced costs [(10,948.12±132.29)vs.(12,131.65±105.36)CNY] (all P<0.05). No postoperative complications such as residual appendicitis or adhesive obstruction were noted in either group during the 3-month follow-up. Two cases of wound infection occurred in the control group and resolved with symptomatic treatment.

Conclusion

Compared with conventional laparoscopic group, single-port laparoscopic appendectomy is safer and more effective for the complex appendicitis in children.