1. Efficacy and safety of retrograde laparoscopic appendectomy in pediatric complicated appendicitis: A 14- year retrospective analysis
- Author
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Mario Riquelme, Carlos Garcia-Hernandez, Irving Alan Cardenas-Medina, Ana Cantu-Zendejas, and Alejandro Cendejas-Higuera
- Subjects
Retrograde laparoscopic appendectomy ,Acute Appendicitis ,Complicated appendicitis ,Laparoscopic Surgery ,Minimally Invasive Surgery ,Laparoscopic Appendectomy ,Pediatrics ,RJ1-570 ,Surgery ,RD1-811 - Abstract
Background: Acute appendicitis is the leading cause of emergency abdominal surgery in children. Complicated cases, particularly those with perforation or gangrene, pose a surgical challenge due to significant inflammation and altered anatomy. Objective: To evaluate the efficacy and safety of retrograde laparoscopic appendectomy (RLA) as an alternative technique in pediatric patients with complicated acute appendicitis, based on data collected over a 14-year period. This study also examines the surgical technique and potential complications associated with RLA. Methods: This retrospective, observational, and descriptive case series analyzed 30 cases of complicated acute appendicitis treated with RLA from a total of 415 laparoscopic appendectomies performed over 14 years. The patients' ages ranged from 4 to 18 years. Dissection began at the appendicular base, progressing retrogradely to the tip. Variables analyzed included operative time, hospital stay, postoperative complications, and conversion rates to open surgery. Results: The study included 19 boys (63 %) and 11 girls (37 %). The average operative time was 75 minutes, and the mean hospital stay was 4 days. There were no conversions to open surgery. Postoperative complications were limited to abscess formation at the port sites in 10 % of cases. No intraoperative complications or residual intra-abdominal abscesses were reported. Conclusion: Retrograde laparoscopic appendectomy (RLA) is a safe and effective technique for managing complicated acute appendicitis in pediatric patients. It is a reproducible procedure for surgeons with experience in laparoscopic techniques, offering a viable alternative in complex cases. Type of study: Retrospective, observational, and descriptive case series. Level of evidence: Level IV
- Published
- 2025
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