[Training in laparoscopy and appendicitis].


BACKGROUND In order to improve laparoscopic skills, appendectomy is the most common procedure because of its high frequency and low difficulty. In spite of that, during the learning curve (each surgeon´s first 35 interventions) the incidence of complications may increase, so improvement in training means a bigger risk for some patients. METHODS We retrospectively reviewed major complications (intra-abdominal abscess, intestinal occlusion, hemorrhage) of 1,710 appendectomies performed at our service between 1997 and 2013. We divided them in three groups: open appendectomy (OA, n= 1,258), laparoscopic appendectomy during the learning curve (LDC, n= 154) and laparoscopic appendectomy after the learning curve (LAC, n= 298). In addition, we distinguish between simple appendicitis (n= 1,233) and peritonitis (n= 477). RESULTS In the OA group we detected110/1,258 major complications (8.7%), 28/154 major complications (18.2%) in the LDC group and 19/298 (6.4%) in the LAC group (p<0.05 LDC vs OA and LAC). In the simple appendicitis group, we found 13/889 major complications (1.5%) in OA, 3/115 (2.6%) in LDC group and 2/229 (0.9%) in LAC group (p= ns LDC vs OA and LAC). In the peritonitis group, 97/369 (26.3%) major complications were found in OA group, 25/39 (64%) in LDC group and 17/69 (24.6%) in LAC group (p<0.05 LDC vs OA and LAC). CONCLUSIONS Educational purpose laparoscopic appendectomy must be used in simple appendicitis cases.

Cite this paper

@article{Ramos2015TrainingIL, title={[Training in laparoscopy and appendicitis].}, author={Josaf{\'a} Lima Ramos and Angel Villanueva and Jos{\'e} Garay and M A Su{\~n}ol and Flor N Villalon and Alex Urbistondo and Jos{\'e}-Luis Martin Jimenez and E Rezola and I{\~n}aki Eizaguirre}, journal={Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica}, year={2015}, volume={28 1}, pages={2-5} }