Abstract
Introduction
Adhesive small bowel obstruction (SBO) is a common postoperative complication. Published
data in the pediatric literature characterizing SBO are scant. Furthermore, the relationship
between the risk of SBO for a given procedure is not well described. To evaluate these
parameters, we reviewed the incidence of SBO after laparoscopic appendectomy (LA)
and open appendectomy (OA) performed at our institution.
Methods
With institutional review board approval, all patients that developed SBO after appendectomy
for appendicitis from January 1998 to June 2005 were investigated. Hospital records
were reviewed to identify the details of their postappendectomy SBO. The incidences
of SBO after LA and OA were compared with χ2 analysis using Yates correction.
Results
During the study period, 1105 appendectomies were performed: 477 OAs (8 converted
to OA during laparoscopy) and 628 LAs. After OA, 7 (6 perforated appendicitis) patients
later developed SBO of which 6 required adhesiolysis. In contrast, a patient with
perforated appendicitis developed SBO after LA requiring adhesiolysis (P = .01). The mean time from appendectomy to the development of intestinal obstruction
for the entire group was 46 ± 32 days.
Conclusions
The overall risk of SBO after appendectomy in children is low (0.7%) and is significantly
related to perforated appendicitis. Small bowel obstruction after LA appears statistically
less common than OA. Laparoscopic appendectomy remains our preferred approach for
both perforated and nonperforated appendectomy.
Index words
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Article info
Footnotes
Papers presented at the 58th Annual Meeting of the Section on Surgery of the American Academy of Pediatrics.
Identification
Copyright
© 2007 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
