Efficacy and safety of retrograde laparoscopic appendectomy in pediatric complicated appendicitis: A 14- year retrospective analysis
Background: Acute appendicitis is the leading cause of emergency abdominal surgery in children. Complicated cases, particularly those with perforation or gangrene, pose a surgical challenge due to significant inflammation and altered anatomy. Objective: To evaluate the efficacy and safety of retrogr...
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Elsevier
2025-04-01
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| Series: | Journal of Pediatric Surgery Open |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S294971162400073X |
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| author | Mario Riquelme Carlos Garcia-Hernandez Irving Alan Cardenas-Medina Ana Cantu-Zendejas Alejandro Cendejas-Higuera |
| author_facet | Mario Riquelme Carlos Garcia-Hernandez Irving Alan Cardenas-Medina Ana Cantu-Zendejas Alejandro Cendejas-Higuera |
| author_sort | Mario Riquelme |
| collection | DOAJ |
| description | Background: Acute appendicitis is the leading cause of emergency abdominal surgery in children. Complicated cases, particularly those with perforation or gangrene, pose a surgical challenge due to significant inflammation and altered anatomy. Objective: To evaluate the efficacy and safety of retrograde laparoscopic appendectomy (RLA) as an alternative technique in pediatric patients with complicated acute appendicitis, based on data collected over a 14-year period. This study also examines the surgical technique and potential complications associated with RLA. Methods: This retrospective, observational, and descriptive case series analyzed 30 cases of complicated acute appendicitis treated with RLA from a total of 415 laparoscopic appendectomies performed over 14 years. The patients' ages ranged from 4 to 18 years. Dissection began at the appendicular base, progressing retrogradely to the tip. Variables analyzed included operative time, hospital stay, postoperative complications, and conversion rates to open surgery. Results: The study included 19 boys (63 %) and 11 girls (37 %). The average operative time was 75 minutes, and the mean hospital stay was 4 days. There were no conversions to open surgery. Postoperative complications were limited to abscess formation at the port sites in 10 % of cases. No intraoperative complications or residual intra-abdominal abscesses were reported. Conclusion: Retrograde laparoscopic appendectomy (RLA) is a safe and effective technique for managing complicated acute appendicitis in pediatric patients. It is a reproducible procedure for surgeons with experience in laparoscopic techniques, offering a viable alternative in complex cases. Type of study: Retrospective, observational, and descriptive case series. Level of evidence: Level IV |
| format | Article |
| id | doaj-art-a8451e1f6a4c46c793e002e9beb11445 |
| institution | DOAJ |
| issn | 2949-7116 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Elsevier |
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| series | Journal of Pediatric Surgery Open |
| spelling | doaj-art-a8451e1f6a4c46c793e002e9beb114452025-08-20T03:14:49ZengElsevierJournal of Pediatric Surgery Open2949-71162025-04-011010018810.1016/j.yjpso.2024.100188Efficacy and safety of retrograde laparoscopic appendectomy in pediatric complicated appendicitis: A 14- year retrospective analysisMario Riquelme0Carlos Garcia-Hernandez1Irving Alan Cardenas-Medina2Ana Cantu-Zendejas3Alejandro Cendejas-Higuera4Division of Pediatric Surgery, Hospital Christus Muguerza, Monterrey, Nuevo Leon, Mexico; Corresponding author at: 15 de Mayo 1822-l, Maria Luisa, Nuevo Obispado, 64040 Monterrey, N.L. , MexicoPrivate Children's Hospital, Mexico City, MexicoMexican Social Security Institute #25, Monterrey, Nuevo Leon, MexicoHospital Christus Muguerza, Monterrey, Nuevo Leon, MexicoHospital Christus Muguerza, Monterrey, Nuevo Leon, MexicoBackground: Acute appendicitis is the leading cause of emergency abdominal surgery in children. Complicated cases, particularly those with perforation or gangrene, pose a surgical challenge due to significant inflammation and altered anatomy. Objective: To evaluate the efficacy and safety of retrograde laparoscopic appendectomy (RLA) as an alternative technique in pediatric patients with complicated acute appendicitis, based on data collected over a 14-year period. This study also examines the surgical technique and potential complications associated with RLA. Methods: This retrospective, observational, and descriptive case series analyzed 30 cases of complicated acute appendicitis treated with RLA from a total of 415 laparoscopic appendectomies performed over 14 years. The patients' ages ranged from 4 to 18 years. Dissection began at the appendicular base, progressing retrogradely to the tip. Variables analyzed included operative time, hospital stay, postoperative complications, and conversion rates to open surgery. Results: The study included 19 boys (63 %) and 11 girls (37 %). The average operative time was 75 minutes, and the mean hospital stay was 4 days. There were no conversions to open surgery. Postoperative complications were limited to abscess formation at the port sites in 10 % of cases. No intraoperative complications or residual intra-abdominal abscesses were reported. Conclusion: Retrograde laparoscopic appendectomy (RLA) is a safe and effective technique for managing complicated acute appendicitis in pediatric patients. It is a reproducible procedure for surgeons with experience in laparoscopic techniques, offering a viable alternative in complex cases. Type of study: Retrospective, observational, and descriptive case series. Level of evidence: Level IVhttp://www.sciencedirect.com/science/article/pii/S294971162400073XRetrograde laparoscopic appendectomyAcute AppendicitisComplicated appendicitisLaparoscopic SurgeryMinimally Invasive SurgeryLaparoscopic Appendectomy |
| spellingShingle | Mario Riquelme Carlos Garcia-Hernandez Irving Alan Cardenas-Medina Ana Cantu-Zendejas Alejandro Cendejas-Higuera Efficacy and safety of retrograde laparoscopic appendectomy in pediatric complicated appendicitis: A 14- year retrospective analysis Journal of Pediatric Surgery Open Retrograde laparoscopic appendectomy Acute Appendicitis Complicated appendicitis Laparoscopic Surgery Minimally Invasive Surgery Laparoscopic Appendectomy |
| title | Efficacy and safety of retrograde laparoscopic appendectomy in pediatric complicated appendicitis: A 14- year retrospective analysis |
| title_full | Efficacy and safety of retrograde laparoscopic appendectomy in pediatric complicated appendicitis: A 14- year retrospective analysis |
| title_fullStr | Efficacy and safety of retrograde laparoscopic appendectomy in pediatric complicated appendicitis: A 14- year retrospective analysis |
| title_full_unstemmed | Efficacy and safety of retrograde laparoscopic appendectomy in pediatric complicated appendicitis: A 14- year retrospective analysis |
| title_short | Efficacy and safety of retrograde laparoscopic appendectomy in pediatric complicated appendicitis: A 14- year retrospective analysis |
| title_sort | efficacy and safety of retrograde laparoscopic appendectomy in pediatric complicated appendicitis a 14 year retrospective analysis |
| topic | Retrograde laparoscopic appendectomy Acute Appendicitis Complicated appendicitis Laparoscopic Surgery Minimally Invasive Surgery Laparoscopic Appendectomy |
| url | http://www.sciencedirect.com/science/article/pii/S294971162400073X |
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