高清福利片

鈥楰eyhole鈥� appendicectomies produce better health outcomes in children up to 16 years finds a new study that compares the post-operative outcomes of open versus laparoscopic appendicectomies (LA).

Led by the University of Sydney, the study was published today in .

Paediatric appendicectomy for acute appendicitis is one of the most common emergency surgeries performed in children.

The study of 23,961 children found a significant increase in the proportion of laparoscopic (keyhole) appendicectomies performed in children between 2002 and 2013, rising from 12 percent to 86 percent. This is the first study to include and assess post-operative emergency department presentations.

鈥淭he results show laparoscopic appendicectomy for children improves outcomes and is associated with a shorter length of hospital stay, compared to open procedure,鈥� said , Research Fellow from University of Sydney鈥檚 Clinical School at the Children鈥檚 Hospital at Westmead.

鈥淐hildren with uncomplicated appendicitis have a lower risk of post-operative complications such as intestinal obstruction after LA compared to open appendicectomy.

鈥淔or cases of complicated appendicitis (with abscess, perforation or peritonitis), the risk of wound infections was lower for LA, but not of intestinal obstruction, or intra-abdominal abscess.

鈥淗owever, LA patients have higher hospital re-admission rates or emergency department presentations related to symptoms such as abdominal pain and fever in children with uncomplicated appendicitis.

鈥淭his suggests that children may be discharged before post-operative symptoms have adequately resolved.鈥�

Co-author from the University鈥檚 Clinical School at the Children鈥檚 Hospital at Westmead said: 鈥淭his study tells us that laparoscopic appendicectomy is safe, with a reduced risk of adhesive bowel obstruction, but a higher risk of minor complications that require re-presentation for assessment or treatment.鈥�

The study also found that post-operative outcomes for children managed in metropolitan, regional or rural general hospitals were not different from those who were treated in tertiary paediatric hospitals regardless of age.

Dr Susan Adams from the Sydney Children鈥檚 Hospital at Randwick and co-author of the study said: 鈥淭his research is important because appendicitis in children is common and it is reassuring that children across NSW have access to safe services to have their appendicitis treated with up to date approaches, including laparoscopic appendicectomy.

鈥淐hildren with appendicitis need to be treated at a hospital with the physical resources and skilled personnel to care for the child. While for some children this will mean being transferred to a children鈥檚 hospital in Sydney or Newcastle,聽for many this level of expertise can be accessed close to home, in the local hospital.聽

Dr Schneuer added: 鈥淥ur study supports the safety of undertaking paediatric appendicectomies outside tertiary paediatric hospitals, which reduces waiting times, delays in care, and unnecessary travel for families of children who need appendicectomies.鈥�

高清福利片 details:

• The study assessed and compared the post-operative outcomes of open and laparoscopic appendicectomy in children under 16 in a public or private hospital in New South Wales between January 2002 and December 2013.
• Of 23,961 children in the study who underwent appendicectomy, 81 percent had uncomplicated appendicitis and 19 percent had appendicitis complicated by abscess, perforation, or peritonitis.
• Post-appendicectomy outcomes were similar for most age groups and hospital types.
• The study used health information from NSW state-wide administrative health datasets.