Background: Perforated appendicitis in children requires surgical intervention and antibiotic treatment after surgery, and may be influenced by surgical technique, the extent of the disease, surgical skill, and hospital protocol. The evidence for pediatrics suggests that laparoscopy will shorten hospital stay, though the findings differ depending on the operative time.
Background: Although the laparoscopic approach to appendectomy has been proven superior to open surgery in adult patients with perforated appendicitis, it has not yet been compared to open surgery in studies of children with perforated appendix.
Objective: To compare the laparoscopic and open appendectomy in a pediatric population with perforated appendicitis with respect to age, operative time, post-operative hospital stay, and other outcomes that were thought to be applicable.
Methods: This was a retrospective comparative cohort study of 103 pediatric patients who underwent appendectomy between 1 June 2024 and 1 June 2026 with the inclusion of patients confirmed as having perforated appendicitis for the study cohort: 54 laparoscopic and 49 open appendectomy. Operative duration, surgical approach, age, admission and discharge dates were analyzed. Between-group comparisons were made using the Mann-Whitney U test and a p value of <0.05 was deemed significant. In the comparative data no individual records of the extent of perforation and/or presence of an accompanying abscess were available.
Results: There were 103 patients included, all of whom had perforated appendicitis and 54 underwent laparoscopy for appendectomy and 49 underwent open appendectomy. Mean age was 9.37 ± 2.68 versus 9.07 ± 3.08 years (p=0.685). Mean operative duration was 54.54 ± 12.71 versus 115.10 ± 17.21 minutes (p<0.001), and mean hospital stay was 3.59 ± 1.11 versus 5.88 ± 2.83 days (p<0.001), respectively. A record of an open surgery was excluded from stay analysis because the date of discharge was impossible to determine.
Results: Laparoscopic appendectomy was found to be related to shorter operative time and less duration of hospitalization in children with perforated appendicitis. The observed findings should be interpreted with caution as there were no controls for the extent of perforation, the number of abscesses, treatment routes, or postoperative complications.