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ORIGINAL RESEARCH article

Front. Pediatr.
Sec. Pediatric Gastroenterology, Hepatology and Nutrition
Volume 13 - 2025 | doi: 10.3389/fped.2025.1537897

Risk Factors and Incidence of Unplanned Re-operation After Transumbilical Single-Hole Laparoscopic Appendectomy in Children

Provisionally accepted
Yuanyuan Luo Yuanyuan Luo Hong Zhang Hong Zhang Qiang Wu Qiang Wu Qianlong Li Qianlong Li Zhihua Ye Zhihua Ye Jixiao Zeng Jixiao Zeng *Xiaogang Xu Xiaogang Xu *
  • Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China

The final, formatted version of the article will be published soon.

    Purpose: This study aims to investigate the factors associated with unplanned re-operations (UR) following transumbilical single-hole laparoscopic appendectomy (TUSILA) in pediatric patients.Methods: We conducted a retrospective analysis of clinical data from children diagnosed with acute appendicitis (AA) who underwent TUSILA at our center between January 2020 and January 2024. All the operations were performed under single-port laparoscopy, including two methods of appendectomy, intra-TUSILA and extra-TUSILA. Patients were categorized into the UR and control groups to compare baseline characteristics, clinical data, postoperative management, and surgical outcomes.Results: The study included 188 patients (110 males and 78 females), with 4 (2.1%) in the UR group. Within the UR group, three cases (75%) necessitated re-operation due to adhesive intestinal obstruction, while one case (25%) was due to an appendiceal remnant fistula. The baseline characteristics, operation duration, intraoperative blood loss, surgeon experience, and postoperative fasting times showed no significant difference between the two groups (all P>0.05). However, the incidences of procedures beyond standard TUSILA, lateral peritoneum lysis, appendiceal perforation, complicated appendicitis as confirmed by pathology, drainage tube placement, and the length of antibiotic duration were significantly higher in the UR group compared to the control group (all P<0.05).Conclusion: A notable percentage of pediatric patients undergoing TUSILA experience UR, primarily due to adhesive ileus, with a substantial proportion potentially linked to surgical technical errors and postoperative management.

    Keywords: Single-hole laparoscopic, acute appendicitis, Children, Appendectomy, Unplanned re-operation, Adhesive intestinal obstruction

    Received: 02 Dec 2024; Accepted: 30 Jan 2025.

    Copyright: © 2025 Luo, Zhang, Wu, Li, Ye, Zeng and Xu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Jixiao Zeng, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
    Xiaogang Xu, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.