TY - JOUR
T1 - Laparoscopic appendectomy for complicated appendicitis in children
T2 - does the post-operative peritoneal drain make any difference? A pilot prospective randomised controlled trial
AU - Human, M. J.
AU - Tshifularo, N.
AU - Mabitsela, M.
N1 - Funding Information:
The authors would like to thank the parents and patients for allowing their children to participate in this study, Department of Paediatric surgery of Sefako Makgatho Academic Hospital (Drs. Adefarakan, Hawu, Kasakanga Maforo, Magwai, Mokaila, Morulana, and Rabutla), The Research Department of SMU, Prof. Herman Schoeman for assisting with the statistics, and Lené Kraft for assisting with the language editing.
Publisher Copyright:
© 2022, The Author(s).
PY - 2022/9
Y1 - 2022/9
N2 - Purpose: This was a pilot randomised, prospective study, which aimed to determine and compare the post-operative complications of paediatric patients undergoing laparoscopic appendectomy (LA) for complicated appendicitis, with and without a peritoneal drain. Methods: Patients younger than 13 years, undergoing LA for complicated appendicitis at the Dr George Mukhari Academic Hospital (DGMAH), over a 15-month period during 2019–2020 were enrolled. Randomisation was achieved by a blocked randomisation plan. Patients were randomised in a 1:1 ratio into the “drain” (D) and “no drain” (ND) groups. Results: Thirty-four patients were included in this study; seventeen in each group. The complication rate was 26%. Intra-abdominal collection accounted for 89% of the complications. The complication rate in the “D” group was 18% and 35% in the “ND” group, with no statistically significant difference. Complication rates were higher (38%) in patients with generalised pus when compared to localised pus (7%), although not statistically significant. The mean theatre time, hospital stay, and duration of antibiotic use did not differ significantly between the groups. Conclusion: From our study, the post-operative peritoneal drain did not make any statistically significant difference in patient outcome. The amount of intra-abdominal contamination is more likely to contribute in the development of complications. Trial registration number: SMUREC/M/15/2019: PG.
AB - Purpose: This was a pilot randomised, prospective study, which aimed to determine and compare the post-operative complications of paediatric patients undergoing laparoscopic appendectomy (LA) for complicated appendicitis, with and without a peritoneal drain. Methods: Patients younger than 13 years, undergoing LA for complicated appendicitis at the Dr George Mukhari Academic Hospital (DGMAH), over a 15-month period during 2019–2020 were enrolled. Randomisation was achieved by a blocked randomisation plan. Patients were randomised in a 1:1 ratio into the “drain” (D) and “no drain” (ND) groups. Results: Thirty-four patients were included in this study; seventeen in each group. The complication rate was 26%. Intra-abdominal collection accounted for 89% of the complications. The complication rate in the “D” group was 18% and 35% in the “ND” group, with no statistically significant difference. Complication rates were higher (38%) in patients with generalised pus when compared to localised pus (7%), although not statistically significant. The mean theatre time, hospital stay, and duration of antibiotic use did not differ significantly between the groups. Conclusion: From our study, the post-operative peritoneal drain did not make any statistically significant difference in patient outcome. The amount of intra-abdominal contamination is more likely to contribute in the development of complications. Trial registration number: SMUREC/M/15/2019: PG.
KW - Complicated appendicitis
KW - Laparoscopy
KW - Peritoneal drain
KW - Prospective
KW - Randomised
UR - http://www.scopus.com/inward/record.url?scp=85133264019&partnerID=8YFLogxK
U2 - 10.1007/s00383-022-05155-6
DO - 10.1007/s00383-022-05155-6
M3 - Article
C2 - 35771234
AN - SCOPUS:85133264019
SN - 0179-0358
VL - 38
SP - 1291
EP - 1296
JO - Pediatric Surgery International
JF - Pediatric Surgery International
IS - 9
ER -