Postoperative recovery assessment after appendectomy in children – laparoscopic versus open technique

Abstract

Introduction/Objective Surgery is a “gold standard” in treating the acute appendicitis in pediatric patients. The aim of the study was to determine the effect of open and laparoscopic appendectomy on postoperative recovery, return to everyday activities, and the quality of life in patients operated on for acute appendicitis.

Methods This prospective study was performed at the Institute for Children and Youth Healthcare of Vojvodina, over a period of 10 months. This study was approved by the Ethics Committee of the Institute. All patients treated for acute appendicitis by surgery were divided into two basic groups – open or laparoscopic appendectomy – and into three subgroups, depending on the degree of appendicitis. We analyzed the length of surgery, oral intake, establishing peristalsis, hospital stay, return to everyday activities, and the quality of life after surgery.

Results Laparoscopic technique was performed in 60 patients (48%), and the open method in 65 patients (52%). In 66.7% of laparoscopically treated patients, peristalsis occurred earlier (p < 0.001), length of hospital stay was shorter (5.95 ± 1.21 days) (Z = -3.054; p = 0.002), the total score of daily activities showed a statistically significantly better score (Z = -7.667; p = 0.000), and they achieved a high level of quality of life significantly earlier (t = 2.773; p = 0.007).

Conclusion The advantages of minimally invasive surgery in the treatment of acute appendicitis in children are reflected in the faster re-establishment of everyday functioning, faster recovery, and a good quality of life.

Keywords: appendicitis; minimally invasive surgery; return to everyday activities; quality of life; children