Dr Omer Aziz and colleagues conducted a meta-analysis to compare laparoscopic and open appendectomy in a pediatric population.
A meta-analysis of laparoscopic versus open appendectomy in a pediatric population has not previously been performed.
The investigative team searched for comparative studies published between 1992 and 2004.
The investigators included a total of 23 studies assessing laparoscopic versus open appendectomy in 6477 children.
Endpoints included postoperative pyrexia, ileus, wound infection, intra-abdominal abscess formation, operative time, and postoperative hospital stay.
The investigators found that wound infection was significantly reduced with laparoscopic versus open appendectomy.
| Wound infection was reduced with laparoscopic vs open appendectomy|
|Annals of Surgery|
The team also noted that ileus was reduced with laparoscopic compared with open appendectomy.
Intra-abdominal abscess formation was more common following laparoscopic surgery, however, this was not statistically significant.
Subgroup analysis of randomized trials did not reveal significant difference between the 2 techniques in any of the 4 complications.
The team observed that operative time was not significantly longer in the laparoscopic group.
Postoperative stay was significantly shorter the laparoscopy.
Sensitivity analysis identified lowest heterogeneity when only randomized studies were considered, followed by prospective, recent, and finally large studies.
Dr Aziz's team commented, “The results of this meta-analysis suggest that laparoscopic appendectomy in children reduces complications.”
“However, we also see the need for further high-quality randomized trials comparing the 2 techniques, matched not only for age and sex but also for obesity and severity of appendicitis.”