Laparoscopic versus open appendectomy in children: a randomized controlled trial from a developing country.

Background: Acute appendicitis is a common surgical emergency. This study was conducted to compare the outcome in terms of duration of surgery, length of hospital stay, and wound infection rate following laparoscopic versus open appendectomy in children with acute appendicitis.

Methods: A prospective randomized controlled trial was conducted. Patients with the diagnosis of acute appendicitis were randomly assigned to Group A: Laparoscopic appendectomy (LA) and Group B: Open appendectomy (OA). Age and sex of patients, signs, and symptoms were noted. Duration of surgery, length of hospital stay (LOS), and postoperative wound infection were recorded.

Results: A total of 126 patients were operated, with 63 in each group. Mean age of the patients was 9.7±2.1years in LA group and 9.8±2.3years in OA group. In LA group, inflamed appendix was found in 68% patients, perforated in 17%, gangrenous in 9%, and suppurative in 5%. In OA group, inflamed appendix was found in 60% patients, perforated in 22%, gangrenous in 5%, and suppurative in 13%. The mean duration of operation was 56±24min in LA group and 39±8min in OA group (p<0.0001 in favor of OA group). The mean length of hospital stay was 34±13h in LA group and 40±11h in OA group (p=0.01 in favor of LA group). The results showed no significant association of wound infection between the two groups (p=0.31).

Conclusions: There was no difference in terms of LOS and rate of wound infection among the groups. However, the laparoscopic procedure was technically demanding. Methods: Level I Randomized Controlled Trial.