Kim Vanderlinden, Toon De Backer Dienst kinderchirurgie, UZ Brussel A single-centre, 10-year retrospective study of appendectomy in children, with emphasis on the postoperative complications. Kim Vanderlinden, Toon De Backer Dienst kinderchirurgie, UZ Brussel BESPGHAN – BELAPS congress, Mechelen, 22th October 2016

Aim of the study To analyse retrospectively our patient series Focus on postoperative complications following appendectomy Kim Vanderlinden, Toon De Backer 22-10-2016

Method Retrospective Single institution: UZ Brussel 10-year consecutive series (2004-2013) Exclusion of incidental and interval appendectomies Patients from 0 to 15 years median 10 years 61% male - 39% female Kim Vanderlinden, Toon De Backer 22-10-2016

Number of patients Kim Vanderlinden, Toon De Backer 22-10-2016

Age 0 – 5 years: 59 patients 6 – 10 years: 246 patients 11 - 15 years: Kim Vanderlinden, Toon De Backer 22-10-2016

Technique for appendectomy Kim Vanderlinden, Toon De Backer 22-10-2016

Technique for appendectomy: evolution Kim Vanderlinden, Toon De Backer 22-10-2016

Postoperative complications following appendectomy Intra-abdominal abscess Surgical wound infection Rehospitalization for pain and/or fever Mechanical ileus (adhesions) Perforation of appendiceal stump Kim Vanderlinden, Toon De Backer 22-10-2016

Group I: uncomplicated appendicitis Inflamed appendix Hyperemia and edema Fibrinous exudate Kim Vanderlinden, Toon De Backer 22-10-2016

Group II: complicated appendicitis Classified intraoperatively as having gangrenous appendicitis (necrosis) perforated appendicitis with an abscess perforated appendicitis with peritonitis (regional or diffuse) Kim Vanderlinden, Toon De Backer 22-10-2016

Results Complicated appendicitis Necrosis Abscess Peritonitis Kim Vanderlinden, Toon De Backer 22-10-2016

Results Kim Vanderlinden, Toon De Backer 22-10-2016

Complications in group I (uncomplicated appendicitis): 3,1% Kim Vanderlinden, Toon De Backer 22-10-2016

Complications in group II (complicated appendicitis): 32,5% Kim Vanderlinden, Toon De Backer 22-10-2016

Age Serious complications occurred more frequently in the younger children Kim Vanderlinden, Toon De Backer 22-10-2016

Age 0 – 5 years: 59 patients 6 – 10 years: 246 patients 11 - 15 years: Kim Vanderlinden, Toon De Backer 22-10-2016

Age 0 – 5 years: 59 patients 6 – 10 years: 246 patients 11 - 15 years: 24 uncomplicated (41%) 35 complicated (59%) 198 uncomplicated (80%) 48 complicated (20%) 227 uncomplicated (84%) 43 complicated (16%) Kim Vanderlinden, Toon De Backer 22-10-2016

Age Kim Vanderlinden, Toon De Backer 22-10-2016

Conclusion Appendicitis in young children (< 6 years) is more frequently complicated at the moment of diagnosis/surgery - in comparison with older children Serious complications occurred more frequently in the younger children Kim Vanderlinden, Toon De Backer 22-10-2016

Conclusion Importance of high index of suspicion recognize every appendicitis in the earliest stage of the disease operate without delay especially with the youngest children in mind Kim Vanderlinden, Toon De Backer 22-10-2016

The end Questions? Kim Vanderlinden, Toon De Backer 22-10-2016