PT  - JOURNAL ARTICLE
AU  - Chowdhury, Mohammad Zonaid
AU  - Farooq, Md Abdullah Al
AU  - Rahman, M A Mushfiqur
AU  - Chowdhury, Tanvir Kabir
TI  - Management of early appendicular lump in children - laparoscopic technique versus open surgery: a comparative study in low-middle income country perspective
AID  - 10.1136/wjps-2020-000131
DP  - 2020 Jul 01
TA  - World Journal of Pediatric Surgery
PG  - e000131
VI  - 3
IP  - 2
4099  - http://wjps.bmj.com/content/3/2/e000131.short
4100  - http://wjps.bmj.com/content/3/2/e000131.full
SO  - World Jnl Ped Surgery2020 Jul 01; 3
AB  - Background In the pediatric population, appendectomy is one of the most common emergency operations. Laparoscopic appendectomy (LA) is an accepted way of dealing with suspected uncomplicated appendicitis in children. The role of laparoscopy in appendicular lump is more controversial and remains undefined and is not well practiced in low-middle income countries. The aim of this study was to determine a better surgical treatment plan for early appendicular lump in children.Methods This prospective observational study was performed in Pediatric Surgery Department of Chittagong Medical College and Hospital for a period of 1 year from April 2018 to March 2019. Sixty children with appendicular lump selected consecutively as per eligibility criteria underwent either LA or open appendectomy (OA), that is, 30 children per group. They were followed up until hospital discharge to observe outcomes.Results There were no differences in terms of patient’s age, sex, clinical presentation and laboratory findings between the two groups. Postoperative pain severity was significantly less in the LA group than that in the OA group (p<0.01). The incidence of wound infection was significantly lower in the LA group than that in the OA group (6.7% in LA and 46.7% in OA; p<0.01). Children in the LA group had a shorter duration of hospital stay in comparison to the OA group [median (IQR) was 8 (5.75–11.25) days and 12 (7.75–18.00) days, respectively, in LA and OA groups; p=0.01].Conclusion The study findings suggest that LA is feasible and should replace OA in cases of early appendicular lump in children.