PubMed · 7837603
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H Ohi, H Nishimata. 1994. [Tubercular appendicitis].. https://pubmed.ncbi.nlm.nih.gov/7837603/
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BACKGROUND: This pilot study was performed to reassess the widespread postulate that laparoscopic surgery is contraindicated in cases of perforating appendicitis. METHODS: A total of 75 children (appendiceal perforation: n = 67; perityphlic abscesses and peritonitis: n = 8) were analyzed in a prospective nonrandomized trial. Ten of them were treated by laparoscopic appendectomy. RESULTS: In the laparoscopy group, both pain and hospitalization were less time-consuming (i.e., by 50% and 19%, respectively). Antibiotics use was down from 2.6 over 6 days to 2.2. over 5.5 days, while the duration of surgery was up by 52%. Wound healing disturbances occurred in 10% (n = 1) and postoperative fever in 50% (n = 5) of patients, compared to 14% (n = 9) and 15% (n = 10) in the group treated by open surgery. All severe complications requiring reintervention (10%; massive subcutaneous abscess, n = 3; retrocolic abscess, n = 2; adhesion-related ileus, n = 3; appendicular stump, n = 1) were associated with open surgery. CONCLUSIONS: There was not a single major complication in the laparoscopy group. These unexpected results are in contrast to previous reports and have prompted us to initiate a prospective randomized trial.
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The advanced practice nurse (APN) functions in pediatric surgery in a variety of ways. In the inpatient setting, the APN can provide care to infants and children with many complex congenital and other surgical anomalies. In the outpatient office, the role includes diagnosis, management, education, and care coordination for children with both routine and complex diagnoses. This article discusses the differences in some of these roles and a few of the common diagnoses seen by the APN in a pediatric surgical practice on a routine day.