Transumbilical Laparo-Assisted Appendectomy : A Safe Operation for the Whole Spectrum of Appendicitis in Children—A Single-Centre Experience

الملخص EN

The paper reports the results of a retrospective review of the medical charts of 203 patients admitted to a pediatric surgical unit with a diagnosis of acute appendicitis between January 2006 and December 2010 when a transumbilical laparoscopic-assisted appendectomy (TULAA) was introduced as a new surgical technique.

Among 203 admitted patients, 7 (3.5%) had a localized appendiceal abscess and were treated with antibiotics.

All of them responded to antibiotics and underwent TULAA interval appendectomy 8 weeks later.

196 patients (96.5%) underwent immediate surgery.

In 12/181 (6.6%) urgent cases, conversion to laparotomy was necessary, in 3 patients because of bowel distension and in 9 for retrocecal position of appendix.

In all 181 TULAA completed procedures, one trocar was used in 151 cases (89.4%), two trocars in 16 (9.4%), and three trocars in 2 (1.2%).

The mean operative time for single port TULAA was 52′ Complications included 5 wound infections and 5 intra-abdominal abscesses, all managed conservatively.

In conclusion, TULAA is a safe, minimally invasive approach with acute appendicitis, regardless of the perforation status, and can be recommended in the pediatric urgical settings.