WOFAPS 2025 8th World Congress of Pediatric Surgery

Ana Ramirez Calazans, Francisco Javier Murcia Pascual, María Rosa Ibarra Rodriguez, Rosa María Paredes Esteban

Hospital Universitario Reina Sofía- Córdoba- Spain

INTRODUCTION

Single-port transumbilical video-assisted appendectomy has become an increasingly alternative in the management of complicated acute appendicitis (CAA) in children. The aim of this review is to report the surgical outcomes of this approach in the treatment of CAA and compare it with standard laparoscopic technique.

MATERIAL AND METHODS

Retrospective study of CAA treated on a 2-years period (2022-2024) using video-assisted (G1) or laparoscopic (G2) technique. Sociodemographic characteristics, type of appendicitis, surgical time, length of stay (LOS) and post-surgical complications were studied, considering complicated appendicitis from the gangrenous stage.

RESULTS

39 patients underwent minimally invasive surgery for CAA, 17 using video-assisted technique and 22 using conventional laparoscopy. Mean age of 8.7±3.1 years (2-13 years). 70.6% treated in G1 were gangrenous, 11.8% perforated and 17.6% generalized peritonitis, compared to 40.9%, 36.4%, 22.7% treated in G2 (p=0.139). Mean surgical time of 70.1±20 minutes for G1 vs 88.7±33.2 minutes for G2(p=0.049). LOS was 3.2±1.8 days for G1 and 4.6±2.4 days for G2 (p=0.059). Related to post-surgical complications, wound infection 5.8% in G1 vs 4.5% in G2, (p=0.851) and no intra-abdominal abscess in G1 and 27.2% in G2 (p=0.019). No patient was readmitted in G1, while in G2 readmission rate was 22.7% (p=0.035)

CONCLUSIONS

Video-assisted appendectomy appears to be a safe and efficient modality for treatment of CAA in children without increased morbidity. Comparing it with conventional laparoscopy, we observed a significant reduction in surgical time, without an increase in post-surgical complications or readmisión rate.