Appendix Diseases, Surgery
Conditions
Keywords
laparoscopic surgery, complicated appendicitis
Brief summary
Observational retrospective study included 765 children with Operative management by laparoscopic appendectomy, conservative management for appendicular mass and drainage of abscess by IR should be tried first. Interval appendectomy is reserved only for patients with recurrent symptoms. the study collect the Diagnostic data ,intraoperative and post operative data to submit the strategies of laparoscopic management in limited resources setting.
Detailed description
Background and study aims: In children with complicated appendicitis significant morbidity exists with prolonged hospitalization and increased costs. The management strategy for complicated pediatric appendicitis differs depending on facility resources together with surgeon's experience. Various studies investigated the usefulness of laparoscopic than open surgery even in complicated appendicitis. However, the treatment strategy remains controversial, especially in appendicular mass as well as appendicular abscess. Methods: This observational study included 765 children with complicated appendicitis. over 10 years period. Patients' demographics, clinical criteria for different presentations of complicated appendicitis, diagnostic work up, plans of treatment based on laparoscopic management were reviewed and analyzed regarding different variables and postoperative outcomes.
Interventions
PROCEDURElaparoscopic appendectomy
Based on clinical findings, imaging studies and laboratory findings, after resuscitation, the decision of urgent surgery was according to the presentation Free peritoneal perforation (FPA) Perforated appendicitis with free peritoneal fluid were managed by urgent laparoscopic exploration Appendicular mass (AM) In patients presented by early mass formation lap exploration was carried out but trial of conservative management was planned for cases presented late with expected difficulty in lap dissection depending on surgical team and parental consultation, this accomplished by (nothing per mouth, I V fluid, I V antibiotic, temperature chart with U/S and biomarker follow up) Appendicular abscess (AAbs) Percutaneous drainage by availability IR team was the first choice however lap exploration and /or lap assisted extraperitoneal drainage was the second choice if IR failed or not available.
Sponsors
Mohammad Daboos
South Valley University
Tanta University
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
Single Group Assignment Pediatric patients aged less than 18 years, with Complicated appendicitis (with mass, appendicular abscess, and free collection) received surgical intervention with laparoscopy
Eligibility
Sex/Gender
ALL
Age
No minimum to 18 Years
Healthy volunteers
No
Inclusion criteria
* laparoscopic management of Complicated Appendicitis with mass formation * laparoscopic management of Complicated appendicitis with abscess formation: * laparoscopic management of Complicated appendicitis with free intraperitoneal collection
Exclusion criteria
* Open surgery cases * Patients received incomplete antibiotic therapy * Accidental discovery coexistent pathology that necessitates open surgery
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Primary outcomes | 4 years | postoperative outcomes any alarming symptoms of intestinal obstruction developed (vomiting, fever, or severe abdominal pain, intraperitoneal collections |
Countries
Egypt
Contacts
PRINCIPAL_INVESTIGATORMohammad Daboos, Dr
Department of pediatric surgery, faculty of medicine , Al-Azhar University
Outcome results
None listed