Laparoscopic Appendectomy in Children With Retrocecal Appendicitis:Report of 57 Cases
10.3969/j.issn.1009-6604.2024.07.004
- VernacularTitle:儿童盲肠后位阑尾腹腔镜切除:附57例报告
- Author:
Xuelai LIU
1
;
Mao YE
;
Zhen CHEN
Author Information
1. 首都儿科研究所附属儿童医院普通外科,北京 100020
- Keywords:
Retrocecal appendix;
Laparoscopy;
Appendectomy;
Children
- From:
Chinese Journal of Minimally Invasive Surgery
2024;24(7):484-487
- CountryChina
- Language:Chinese
-
Abstract:
Objective To summarize the experience of laparoscopic appendectomy in children with retrocecal appendicitis.Methods Between October 2019 and February 2024,57 children with retrocecal appendicitis were confirmed in three-port laparoscopic appendectomy operations in this department.A 5 mm trocar and a 30°observation laparoscope were inserted through the umbilical midline incision.A 5 mm trocar and operating forceps were inserted through the midline above the bladder in the lower abdomen and the outer edge of the left rectus abdominis muscle 3-5 cm below the umbilicus,respectively.The laparoscopic forceps were inserted into the abdomen cavity to search and ligate the root of the appendix.An electric hook was used to detach the blind end and body of the appendix with combination of forward and reverse cutting.If the appendix was located outside of retroperitoneum,the electric hook was used to open retroperitoneum aiming to expose the appendix,followed by releasing,detaching and cutting the appendix.Results The operations were successfully completed in all the 57 cases.The operating time was 65-120 min(mean,85.0±10.5 min).All the patients got out of bed and moved around at 8-12 h after surgery and passed flatus and took liquid diet at 0.5-2 d after surgery.The postoperative hospital stay was 3-7 d(mean,5.5 d).The follow-ups time ranged from 1 to 18 months(mean,5.7 months).No complications were noted,including wound infection,adhesive intestinal obstruction,appendiceal stump inflammation or pelvic abscess.Conclusions The retrocecal appendix is closely attached to the cecal wall,leading to a relatively long surgical time.During the operation,the root of the appendix should be ligated firstly,and the appendix be detached closely to the appendix wall.The combination of forward and backward appendectomy during the surgery should be emphasized.In case the appendix is located outside of the retroperitoneum,the lateral retroperitoneum should be opened with an electric hook to expose the appendix,and the appendix should be removed by combining forward and reverse cutting.
