Laparoscopic Appendectomy in Children With Perforated Appendicitis: A Meta-Analysis

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Background:The purpose of this meta-analysis was to compare the influence of different surgical procedures on perforated appendicitis in pediatric population.Materials and Methods:Studies were identified through a computerized literature search of Pubmed, Embase, Ovid, the Cochrane Colorectal Cancer Group Controlled Trials Register, the Cochrane Central Register of Controlled Trials, the Cochrane Library database, and Web of Science. Two reviewers independently assessed the quality of each study and abstracted outcome data. Data were extracted comparing laparoscopic appendectomy (LA) and open appendectomy (OA) in pediatric population with regard to several postoperative variables. We synthesized published data using fixed-effect models, expressing results as relative risk (RR).Results:Nine eligible studies were included which came from various medical centers all over the world. Statistically significant differences between “LA” and “OA” groups were found for wound infection (RR=0.88), intra-abdominal abscess (RR=1.38), and bowel obstruction (RR=0.79).Conclusions:Our meta-analysis found that LA is associated with lower incidence of wound infections and bowel obstruction, but the rate of intra-abdominal abscess was higher than OA.

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