| Title |
One-trocar versus multiport hybrid laparoscopic appendectomy: What’s the best option for children with acute appendicitis? Results of an international multicentric study
|
|---|---|
| Published in |
Surgical Endoscopy, March 2016
|
| DOI | 10.1007/s00464-016-4832-y |
| Pubmed ID | |
| Authors |
Ciro Esposito, Maria Escolino, Holger Till, Mirko Bertozzi, Giovanna Riccipetitoni, Alessandro Settimi, Francois Varlet |
| Abstract |
One-trocar laparoscopic appendectomy (OTA) is routinely adopted in children with acute appendicitis. In case of a difficult appendectomy, it is necessary to add additional trocar/s to safely complete the procedure. This technique is called multiport hybrid laparoscopic appendectomy (HLA). We aimed to compare the outcome of multiport HLA versus OTA. We retrospectively reviewed the data of 1,092 patients underwent LA in 5 European centers of pediatric surgery in the last 5 years. We compared 2 groups: G1 of 575 patients (52.6 %) (average age 10 years) underwent OTA and G2 of 517 patients (47.4 %) (average age 8.2 years) underwent multiport HLA. No intra-operative complications occurred in both groups. An additional pathology was treated in 12 cases (8 Meckel's diverticulum, 2 carcinoids, 2 ovarian cysts) in G2. Operative time was significantly shorter in G2 compared to G1 (47.8 vs 58.6 min; p < .001). The average analgesic requirement was significantly shorter in G2 compared to G1 (44 vs 56 h; p < .001). As for postoperative complications, the incidence of port-site infections was similar between the two groups, while the incidence of postoperative abdominal abscesses (PAA) was significantly higher in G1 compared to G2 (4.7 vs 0.2 %; p < .001). The cosmetic outcome was excellent in all patients of both groups. A subgroup analysis between complicated and uncomplicated appendicitis showed that only in complicated cases, the average operative time, the average VAS pain score, the average analgesic requirements and the incidence of PAA were significantly higher in OTA group compared to multiport HLA group (p < .001). Our results suggest that OTA is a valid and safe procedure for the uncomplicated cases, while additional trocars are required in case of complicated appendicitis. Multiport HLA significantly reduces the operative time, the incidence of abdominal abscesses and the analgesic requirements compared to OTA. |
Mendeley readers
The data shown below were compiled from readership statistics for 41 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 41 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 7 | 17% |
| Other | 6 | 15% |
| Student > Bachelor | 6 | 15% |
| Librarian | 3 | 7% |
| Student > Postgraduate | 2 | 5% |
| Other | 7 | 17% |
| Unknown | 10 | 24% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 23 | 56% |
| Arts and Humanities | 1 | 2% |
| Environmental Science | 1 | 2% |
| Biochemistry, Genetics and Molecular Biology | 1 | 2% |
| Pharmacology, Toxicology and Pharmaceutical Science | 1 | 2% |
| Other | 2 | 5% |
| Unknown | 12 | 29% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 05 March 2016.
All research outputs
#20,313,158
of 22,854,458 outputs
Outputs from Surgical Endoscopy
#5,654
of 6,045 outputs
Outputs of similar age
#252,357
of 298,940 outputs
Outputs of similar age from Surgical Endoscopy
#89
of 104 outputs
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