Aydın YAĞMURLU, Tanju AKTUĞ, Hüseyin DİNDAR, Haluk GÖKÇORA, Bingöl Meltem KOLOĞLU, Rahşan VARGÜN, Hülya ÖZKAN

Management of childhood appendicitis: Laparascopic versus open approach

Amaç: Çocukluk çağında laparoskopik apendektomi halen tartışmalıdır. Laparoskopik ve açık apendektomi yapılmış olan çocukların dosyaları geriye dönük olarak incelenip sonuçlar karşılaştırıldı. Hastalar ve Yöntem: Apendisit tanısıyla 36 aylık sürede apendektomi yapılmış olan 337 çocuk çalışmaya dahil edildi. Ameliyat sonrası kesi yeri enfeksiyonu, karın içi abse gelişimi ve brid ileus çalışmanın birincil sonuç kriterleri olarak belirlendi. Çalışmanın ikincil sonuç kriterleri ameliyat süresi, oral besleme zamanı, ağrı kesici ihtiyacı ve hastanede kalış süresi olarak saptandı. Bulgular: Çocukların 126'sına (%39.8) laparoskopik apendektomi (LA), 188'ine (%59) açık apendektomi (AA) yapıldı. Laparoskopik gruptaki üç hastada (%1) açık apendektomiye geçildi. Ameliyat süreleri LA (52±1.34 dk) ve AA'de (54±1.27 dk) benzerdi (p>0.05). Oral besleme zamanı (AA: 24 ±1.1saat, LA:14±0.5 saat), ağrı kesici ihtiyacı (AA:48±5 saat, LA:24±5 saat) ve hastanede kalış süresi (AA:3.9±0.1 gün, LA:2.8±0.1 gün) açısından gruplar karşılaştırıldığında LA grubunda daha kısa olduğu görüldü (p

Çocuklarda laparoskopik ve açık apendektomi sonuçlarının karşılaştırılması

Aim: Laparoscopic management of pediatric appendicitis remains controversial. A retrospective chart review was performed to compare laparoscopic versus open approach in the treatment of childhood appendicitis. Patients and Methods: Three hundred thirty seven children who underwent appendectomy with preoperative diagnosis of appendicitis over a 36-month period were included to the study. Primary outcome measures were postoperative wound infection, intra-abdominal abscess formation and intestinal obstruction. Secondary outcome measures were the length of operation, time to oral feeding, analgesic need and hospitalization time. Results: Total number of children in laparoscopy group was 126 (39.8%) whereas this number for open group was 188 (59%). There were 3 (1%) conversions in laparoscopy group. Mean length of operative time for laparoscopic (LA: 52 ±1.34 min), and open appendectomy (OA: 54 ± 1.27min), were similar (p>0.05). Time to full enteral feeding (OA: 24 ±1.1h, LA: 14±0.5h), analgesic usage (OA: 48±5h, LA: 24±5h) and length of hospitalization (OA: 3.9±0.1 day, LA: 2.8±0.1 day) were shorter in laparoscopic group compared to the open procedure (p

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