Laparoscopic appendectomy for complicated appendicitis in children: does the post-operative peritoneal drain make any difference? A pilot prospective randomised controlled trial

Pediatr Surg Int. 2022 Sep;38(9):1291-1296. doi: 10.1007/s00383-022-05155-6. Epub 2022 Jun 30.

Abstract

Purpose: This was a pilot randomised, prospective study, which aimed to determine and compare the post-operative complications of paediatric patients undergoing laparoscopic appendectomy (LA) for complicated appendicitis, with and without a peritoneal drain.

Methods: Patients younger than 13 years, undergoing LA for complicated appendicitis at the Dr George Mukhari Academic Hospital (DGMAH), over a 15-month period during 2019-2020 were enrolled. Randomisation was achieved by a blocked randomisation plan. Patients were randomised in a 1:1 ratio into the "drain" (D) and "no drain" (ND) groups.

Results: Thirty-four patients were included in this study; seventeen in each group. The complication rate was 26%. Intra-abdominal collection accounted for 89% of the complications. The complication rate in the "D" group was 18% and 35% in the "ND" group, with no statistically significant difference. Complication rates were higher (38%) in patients with generalised pus when compared to localised pus (7%), although not statistically significant. The mean theatre time, hospital stay, and duration of antibiotic use did not differ significantly between the groups.

Conclusion: From our study, the post-operative peritoneal drain did not make any statistically significant difference in patient outcome. The amount of intra-abdominal contamination is more likely to contribute in the development of complications.

Trial registration number: SMUREC/M/15/2019: PG.

Keywords: Complicated appendicitis; Laparoscopy; Peritoneal drain; Prospective; Randomised.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Appendectomy / adverse effects
  • Appendicitis* / complications
  • Appendicitis* / surgery
  • Child
  • Humans
  • Laparoscopy* / adverse effects
  • Length of Stay
  • Postoperative Complications / etiology
  • Prospective Studies
  • Retrospective Studies
  • Suppuration / complications
  • Suppuration / surgery
  • Treatment Outcome