Analysis of difficulties and influencing factors in treatment of appendiceal abscess in children with laparoscopic surgery.

The purpose of this study was to investigate and analyze the difficulties and influencing factors in the laparoscopic surgery for appendiceal abscess in children. 46 patients with appendiceal abscess receiving laparoscopic surgery (laparoscopic surgery group) in Xuzhou Children's Hospital from January 2012 to March 2017 were retrospectively analyzed. The surgery was performed using the 3-hole method, the 30° lens was placed in umbilical region, and the left lower abdomen and superior pubis were the operating holes. If the appendix was thick and big, 10 mm Trocar was replaced on the superior pubis and the appendix was removed, followed by pelvic or lower abdominal drainage via the superior pubis incision. The laparoscopic surgery group was compared with 45 cases of laparotomy (traditional surgery group) for appendiceal abscess performed by the same group of operators in the past, and the perioperative period and postoperative complications between the two groups were compared. The child patients' age, history of abdominal pain and pre-diagnosis treatment were compared within the laparoscopic surgery group. Compared with those in traditional surgery group, the surgery time in laparoscopic surgery group had no statistically significant difference (p>0.05), the incidence rate of complications was lower, and the difference was statistically significant (p<0.05). In laparoscopic surgery group, the surgery time of child patients aged ≥6 years old with the medical history for more than 5 days and unreasonable preoperative treatment was longer than that of child patients aged <6 years old with the medical history for less than or equal to 5 days and reasonable preoperative treatment, and the difference was statistically significant (p<0.05). Compared with the traditional surgery, laparoscopic surgery for appendiceal abscess in children can significantly reduce the postoperative complications; at the same time, the history of abdominal pain and preoperative treatment are the influencing factors of surgery.