TITLE:
Efficacy of Laparoscopic Approach for Appendicectomy and Orchiopexy across the Pediatric Age and Size Spectrum
AUTHORS:
Narinder Teckchandani, Minu Bajpai, Dalim Kumar Baidya
KEYWORDS:
Pediatric Laparoscopy, Surgical Stress, Appendicectomy, Orchiopexy
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.4 No.3,
September
24,
2014
ABSTRACT: Context: It remains, as
yet, an issue unsettledby
evidence that whether the younger age and smaller size of the pediatricpatient
affect the efficacy of laparoscopy for appendicectomy and intraabdominal
testes. Aims: To prospectively assess the level of difficulty, surgical stress
and outcomes of two commonly done laparoscopic proceduresi.e., appendicectomy and
orchiopexy for intraabdominal testes, across the pediatric age and size
spectrum. Settings and Design: Prospective interventional study conducted in
Pediatric Surgery department of a tertiary hospital.Subjects and Methods: From April 2013
to August 2014, 60 children underwent either laparoscopic interval
appendicectomy or orchiopexy (unilateral or bilateral) by same surgeon.
Difficulty level, metabolic stress and other clinical outcomes of the
laparoscopic procedures were compared across various age groups. Statistical
Analysis: Kruskal-Wallis test was used to compare various age groups with
respect to the study variables. Results: The patients were divided into three
groupswith age ranges of 1 - 6
years, 6 - 9 years and 9 - 13 years. The three groups were very different (P= 0.000) with respect to the body
surface area of included children. Each of the three age groups had a similar
set of 20 laparoscopic proceduresviz.,
10 appendicectomies, 8 unilateral orchiopexies and 2 bilateral orchiopexies.
The three groups had no difference in the total level of difficulty score,
duration of capnoperitoneum, postop increase in serum CRP and blood glucose
levels (surrogates for metabolic stress sustained due to surgery), time to full
orals and postop hospital stay. Conclusion: The younger age and smaller size of
patient do not affect the efficacy of laparoscopic appendicectomy and
orchiopexy.