ArticlePediatric surgery international2018
Conversion from laparoscopic to open appendectomy: decreased risk at dedicated children's hospitals.
Article in Pediatric surgery international, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.
- Daytime versus nighttime appendectomy in term of complications and clinical outcomes: a meta-analysis.International journal of colorectal disease · 2024Pooled it
- Impact of pediatric obesity on abdominal surgery outcome: a narrative review.Frontiers in pediatrics · 2026Review
- The Outcome of Laparoscopic Versus Open Appendectomy in Childhood.Deutsches Arzteblatt international · 2024Article
- Associations between Hospital Setting and Outcomes after Pediatric Appendectomy.Children (Basel, Switzerland) · 2023Article
- Clinical Outcomes of Daytime Versus Nighttime Laparoscopic Appendectomy in Children.Children (Basel, Switzerland) · 2023Article
Corrections and comments
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Authors and funding
3 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe advent of laparoscopy has revolutionized surgical practice within the last 30 years. Conversion to open surgery, however, remains necessary at times, even for the most experienced laparoscopic surgeon.
methodsThe kids' inpatient database was analyzed for 2006, 2009, and 2012 for patients who underwent laparoscopic appendectomy and conversion to open (CPT 470.1 and V64.41, respectively). Variables included in multivariable analysis were determined based on those variables found to have significance on univariate analysis.
resultsA total of 104,865 patients, ages 0-17 years, underwent laparoscopic appendectomy during the three study periods. Of these, 2370 (2.2%) laparoscopic surgeries were converted to open appendectomy. Multivariable logistic regression showed significantly higher rates of conversion amongst patients with peritonitis (OR 6.7, p < 0.001) or abscess (OR 14.3, p < 0.001), obesity (OR 2.02, p < 0.001), age > 13 years (OR 1.53 for ages 13-15, OR 1.77 for ages 16-17, p < 0.001 for both), or cared for at rural hospitals (OR 1.55, p = 0.002). Rates of conversion decreased over time for children at adult hospitals and at urban hospitals, regardless of teaching status (p < 0.001 for both).
conclusionRisk factors for conversion from laparoscopic to open appendectomy included abscess, peritonitis, increased age, obesity, male gender, socioeconomic status and treatment at a non-pediatric-specific hospital, and the overall rate is decreasing over time.
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