Laparoscopic Treatment for Complicated Acute Appendicitis in Children, Junior Athletes

Background: We present our experience in the first 20 cases of complicated acute appendicitis in children, junior athletes, managed laparoscopically. Materials and method: We selected our first 20 patients, aged between 3 and 17 (median age 10), with complicated acute appendicitis treated laparoscopically. We analysed the intra- and postoperative complications, operative time, length of hospitalization and their return period to previous training. Four cases were excluded from the study because they were converted to open appendectomy (OA). Results: One case developed a parietal abscess at the place of insertion of the suprapubic trocar and was treated locally. There were no cases with intraabdominal abscesses to require drainage. Fever on the 3rd postoperative day appeared in one patient which required reassessment of the antibiotic treatment. Length of hospitalization was between 4 and 8 days. The athletes resumed their sports activity after 10 - 12 days. Conclusion: Complicated acute appendicitis (generalized peritonitis, localized abscess, perforated abscess), was once a contraindication for laparoscopic appendectomy (LA). Today LA is the first choice of surgical treatment for most of the surgeons. Due to the limited number of patients we have operated on laparoscopically up to this present paper we cannot draw a statistically significant conclusion, but the good results are encouraging us to continue using this approach as the first line treatment in children and more over for those who need a rapid return to intense physical activity.