National trends in approach and outcomes with appendicitis in children.
BACKGROUND/PURPOSE: Appendicitis is one of the most common surgical conditions in children. Laparoscopy has become the standard approach to appendectomy over the past decade. Some critics cite a lack of evidence documenting clear advantages to laparoscopy. To define the pattern of approach compared to outcomes in the United States, we analyzed the Pediatric Health Information System (PHIS) database to document the impact on outcomes with the rise in laparoscopy.
METHODS: After IRB approval, we queried the PHIS database for all patients over 12 years. The percentages of cases performed open (OA) and laparoscopically (LA) were established for each year. Annual complication percentages were identified for wound infection, intra-abdominal abscess, subsequent laparotomy, and obstruction. For each complication, trend comparisons between LA and OA were made with generalized linear models.
RESULTS: There were 111,194 appendectomies with a positive trend in percentage of laparoscopy from 1999 (22.2%) to 2010 (90.8%), P
CONCLUSIONS: On the basis of a national database analysis, laparoscopy has increased for appendectomy in children over the past 12 years and is associated with a significant decrease in post-operative complications.
Journal of pediatric surgery
Adolescent; Age Distribution; Appendectomy; Appendicitis; Child; Child, Preschool; Confidence Intervals; Databases, Factual; Female; Follow-Up Studies; Humans; Incidence; Laparoscopy; Laparotomy; Male; Odds Ratio; Postoperative Complications; Retrospective Studies; Risk Assessment; Sex Distribution; Treatment Outcome; United States
Gasior, Alessandra C.; St Peter, Shawn D.; Knott, E Marty; Hall, Matt; Ostlie, Daniel J.; and Snyder, Charles L., "National trends in approach and outcomes with appendicitis in children." (2012). Manuscripts, Articles, Book Chapters and Other Papers. 716.