Abstract

Purpose

Transumbilical laparoscopic‐assisted surgery (TULS) mixed benefits of laparoscopic and open surgeries. Transumbilical laparoscopic-assisted appendectomy (TULAA) is a well-known procedure, accepted and currently used by pediatric surgeons for treatment of uncomplicated appendicitis (UA). There is no current agreement in its use for the complicated appendiceal infections (CA). We reported our results using TULAA for both UA and CA.

Methods

We retrospectively collected TULAA performed between April 2017 and April 2022. Appendicitis were classified in UA and CA. We analyzed conversion rate, operative time, length of stay, surgical site infections (SSIs) rate, postoperative intra-abdominal abscess and costs.

Results

Over 5 years, 316 children underwent TULAA. Conversion rate was 3%. Mean age at surgery was 9.36 years (IQR 2–16). Forty-nine appendicitis were CA. Operative time and hospital stay was higher in CA than in UA group (38.33 vs. 60.73 min, p < 0.00001; 4 vs. 7 days, p < 0.00001). SSIs rate showed no statistically significant difference between two groups. Incidence of postoperative intra-abdominal collections was 11% in CA and 1% in UA. TULAA’s cost was 192.07 €.

Conclusion

In our series, TULAA seems to be safe, feasible and cost-effective for both uncomplicated and complicated appendicitis, with no disadvantage in terms of outcomes compared to what is reported in literature for CLS.

中文翻译：

---

经脐腹腔镜辅助阑尾切除术治疗复杂性阑尾炎是否可行？单中心体验

摘要

目的

经脐腹腔镜辅助手术（TULS）兼具腹腔镜手术和开放手术的优点。经脐腹腔镜辅助阑尾切除术（TULAA）是一种众所周知的手术，目前被小儿外科医生接受并用于治疗简单性阑尾炎（UA）。目前尚未就其用于复杂阑尾感染（CA）的使用达成一致。我们使用 TULAA 报告了 UA 和 CA 的结果。

方法

我们回顾性收集了2017年4月至2022年4月期间进行的TULAA。阑尾炎分为UA和CA。我们分析了转化率、手术时间、住院时间、手术部位感染（SSI）率、术后腹内脓肿和费用。

结果

5 年来，316 名儿童接受了 TULAA。转化率为3%。手术时的平均年龄为 9.36 岁（IQR 2-16）。 49 例阑尾炎为 CA。 CA 组的手术时间和住院时间高于 UA 组（38.33 分钟 vs. 60.73 分钟，p  < 0.00001；4 天 vs. 7 天，p  < 0.00001）。两组之间的 SSI 率无统计学差异。 CA 术后腹腔内积液的发生率为 11%，UA 为 1%。 TULAA 的成本为 192.07 欧元。

结论

在我们的系列中，TULAA 对于单纯性和复杂性阑尾炎似乎都是安全、可行且具有成本效益的，与文献报道的 CLS 相比，在结果方面没有劣势。