Role of Laparoscopy in Appendicular Mass among Pediatric Age Group With or Without Perforation: Early Outcome

Abstract
Background: Laparoscopic appendectomy is a safe, fea-sible and effective technique for complicated appendicitis such as mass, abscess and perforation in pediatric patients. Laparoscopic approach had several advantages over open appendectomy in that, it allow proper and wide visualization of the abdominal cavity.
Aim: Our aim is to evaluate the feasibility and safety of laparoscopy in cases of appendicular mass among pediatric age group with or without perforation.
Material and Methods: This study was carried out on fourty children presented by complicated appendicitis (perfo-ration, mass or abscess) with history less than 72 hours, aged between 4 and 18 years and scheduled for laparoscopic ap-pendectomy. Antibiotic regimen consisted of daily intravenous administration of (cefotiam, 80mgkg/24h) for 5 days intrave-nously and metronidazole (20mg/kg/24h) for 5 days intrave-nously, oral antibiotics (cefuroxime + metronidazole) were continued for another 1 week.
Results: Intraoperative findings were 17 cases acute perforated appendicitis, 13 cases appendicular mass, two patients were converted to open appendectomy. Analysis revealed presence of gangrenous appendicitis in 75% and suppurative (Phlegmonous) appendicitis in 25% of all appen-dices. Post-operative complications were encountered in form of intraperitoneal collection in one, fever in five, umbilical port site infection in two cases.
Conclusions: Laparoscopic appendectomy is a safe, fea-sible and effective technique for complicated appendicitis such as mass, abscess and perforation in pediatric patients. Laparoscopic approach had several advantages over open appendectomy in that, it allow proper and wide visualization of the abdominal cavity, moreover, it is very useful in reaching an exact diagnosis in complicated cases with experience and gentle handling.