Evidence map›Paper›PMID 40569465›Full record

ArticlePediatric surgery international2025

Transumbilical laparoscopic-assisted appendectomy for acute appendicitis in children: appendiceal stump inversion is not necessary-a retrospective study.

Stella Mazzarolo, Alessandro Boscarelli, Manuela Giangreco, Chiara Dobrinja, Daniela Codrich, Maria-Grazia Scarpa, Marianna Iaquinto, Matea Peric-Anicic, Damiana Olenik, Sonia Maita and 2 more

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Article in Pediatric surgery international, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Stella MazzaroloFaculty of Medicine and Surgery, University of Trieste, Trieste, Italy.
Alessandro BoscarelliDepartment of Pediatric Surgery and Urology, Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Via dell'Istria, 65/1, 34137, Trieste, Italy. tboscar@hotmail.it.ORCID http://orcid.org/0000-0003-1934-1764
Manuela GiangrecoClinical Epidemiology and Public Health Research Unit, Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", 34137, Trieste, Italy.ORCID http://orcid.org/0000-0002-4479-3087
Chiara DobrinjaDepartment of Medical, Surgical and Health Sciences, University of Trieste, 34125, Trieste, Italy.
Daniela CodrichDepartment of Pediatric Surgery and Urology, Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Via dell'Istria, 65/1, 34137, Trieste, Italy.ORCID http://orcid.org/0000-0003-2925-8876
Maria-Grazia ScarpaDepartment of Pediatric Surgery and Urology, Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Via dell'Istria, 65/1, 34137, Trieste, Italy.
Marianna IaquintoDepartment of Pediatric Surgery and Urology, Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Via dell'Istria, 65/1, 34137, Trieste, Italy.
Matea Peric-AnicicDepartment of Surgery, University Hospital of Mostar, Mostar, Bosnia and Herzegovina.
Damiana OlenikDepartment of Pediatric Surgery and Urology, Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Via dell'Istria, 65/1, 34137, Trieste, Italy.
Sonia MaitaDepartment of Pediatric Surgery and Urology, Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Via dell'Istria, 65/1, 34137, Trieste, Italy.
Edoardo GuidaDepartment of Pediatric Surgery and Urology, Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Via dell'Istria, 65/1, 34137, Trieste, Italy.ORCID http://orcid.org/0000-0003-4901-2515
Jürgen SchleefDepartment of Pediatric Surgery and Urology, Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Via dell'Istria, 65/1, 34137, Trieste, Italy.ORCID http://orcid.org/0000-0001-9754-2479

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeAcute appendicitis is one of the most common surgical conditions in pediatric and general surgery. The purpose of this study was to retrospectively investigate the management strategies of the appendiceal stump during transumbilical laparoscopic-assisted appendectomy for acute appendicitis in terms of surgical time, hospital length of stay, and postoperative complications.

methodsThe records of patients < 18 years of age who were treated for acute appendicitis at our Pediatric Surgery Unit from December 2018 to January 2024 were retrospectively reviewed. Data were extrapolated from the departmental database, and clinical notes were reviewed.

resultsThe records of 278 patients who underwent appendectomy within a 5-year period at our institution were essentially used to compare appendiceal stump inversion and simple ligation. Appendiceal stump invagination was performed in 208 patients (74.8%), comprising 106 females (51.0%) and 102 males (49.0%), with a median age of 11 years (IQR 8-15) and a median weight of 36.5 kg (IQR 28-54). Twenty-six (12.5%) patients had associated conditions. The appendiceal stump was not invaginated in 70 children (25.2%), consisting of 26 females (37.1%) and 44 males (62.9%), with a median age of 11 years (IQR 8-14) and a median weight of 38.3 kg (IQR 29.5-47). Fourteen patients (20%) had associated pathologies. The two groups were similar in terms of sex (P = 0.05), age (P = 0.40), weight (P = 0.78), and associated pathologies (P = 0.12). Notably, 78.6% of appendicitis cases treated without stump invagination were uncomplicated, whereas 20% were complicated (4.3% abscess and 15.7% peritonitis cases). In contrast, stump invagination was performed in 87% of uncomplicated appendicitis and 13.1% of complicated appendicitis cases (6.8% abscess and 6.3% peritonitis cases). Therefore, simple ligation was also effective in complicated appendicitis cases (P = 0.03). In addition, the median surgical duration was 63.5 min (IQR 46-90) for patients undergoing stump inversion and 69 min (IQR 60-115) for patients undergoing simple ligation respectively (P = 0.02). Interestingly, statistical analysis revealed no significant differences in length of hospital stay (P = 0.21) and postoperative complications (P = 0.15).

conclusionSimple ligation does not compromise treatment efficacy nor increase postoperative complications, nor the length of hospital stay.

Indexed as

AppendectomyAppendicitisAppendixLaparoscopyAdolescentChildFemaleHumansLength of StayMaleOperative TimePostoperative ComplicationsRetrospective StudiesTreatment OutcomeUmbilicusAppendiceal stumpAppendicitisChildrenLaparoscopyTransumbilical

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.