Appendectomy in the pediatric population—a German nationwide cohort analysis

@article{Gosemann2016AppendectomyIT,
  title={Appendectomy in the pediatric population—a German nationwide cohort analysis},
  author={Jan-Hendrik Gosemann and Ansgar Lange and Jan Zeidler and Jochen Blaser and Carmen Dingemann and Benno Manfred Ure and Martin Lacher},
  journal={Langenbeck's Archives of Surgery},
  year={2016},
  volume={401},
  pages={651-659}
}
BackgroundMeta-analyses indicate advantages of laparoscopic compared to open appendectomy. Nationwide analyses on results of laparoscopic appendectomy are scarce and studies from Germany are not available. This observational cohort study based on a nationwide insurance database was performed to analyze results of pediatric laparoscopic versus open appendectomy in general use.MethodsData were extracted from the largest German statutory health insurance TK (∼9 million clients) in a 3-year period… 
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TLDR
This study, comparing LA versus OA in children, failed to identify any major difference between the two techniques in terms of formation of intra-abdominal abscesses, but showed globally a significant reduced operative time in OA versus LA in complicated appendicitis.
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TLDR
LA is safe in children with acute perforated and nonperforated appendicitis, and is associated with shorter hospital stay than OA, and the laparoscopic approach isassociated with lower morbidity and mortality in perforation cases, however, in nonper forated cases, these benefits are modest and are associated with higher hospital charges.
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TLDR
LA provides considerable benefits over OA, including a shorter length of hospital stay, less postoperative pain, earlier postoperative recovery, and a lower complication rate.
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TLDR
Pooled analysis demonstrates that, in children with uncomplicated acute appendicitis, LA is associated with a reduced hospital stay but broad equivalence in postoperative morbidity when compared with the conventional approach.
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TLDR
Laparoscopic appendectomy is superior or comparable to open appendectomy in terms of several surgical outcome measures for both uncomplicated and complicated appendicitis, across most illness severity groups.
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TLDR
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TLDR
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