Abstract

Aim: Childhood appendicitis may be complicated in 2-9% and children may present with abscess or mass. Management of these patients is still controversial. Currently, one of the most common accepted methods is elective interval appendectomy after treating conservatively at the acute period. The aim of this study is to present the clinical outcomes of patients with plastron appendicitis who were treated by elective laparoscopic interval appendectomy.

Material and Method: The charts of the patients who were diagnosed with plastron appendicitis between 2010 and 2015 were retrospectively evaluated. Demographic data, hospitalization time, presence of abscess, timing of surgery, operation time and postoperative complications were recorded.

Results: There were 36 children with plastron appendicitis who were treated by laparoscopic interval appendectomy. The median age was 10 years (2-18 years). Nine of the patients were girl and 27 of them were boy. Oral intake was stopped and intravenous antibiotics were ordered for all. Intraabdominal abscess was detected in 15 of the cases and ultrasonography-guided percutaneous drainage was performed in five of them. Mean hospitalization time for the first admittance was 5.1 days (3-8 days). The average time from the first hospitalization until surgery was 6.8 weeks (4-18 weeks). All of the cases were treated by laparoscopic interval appendectomy after conservative treatment. Mean operating time was 59.4 minutes (25-110 minutes). Mean of second hospitalization was 3.2 days (1-7 days). There were two early complications (5.5%); paralytic ileus in one patient and incisional infection in another. There were no late complications in six months follow-up.

Conclusion: Laparoscopic interval appendectomy is a safe and effective method in the treatment of childhood plastron appendicitis especially by preventing appendectomy complications at the acute period.