Laparoscopic surgery for severe appendicitis in children: An effect and safety analysis

doi:10.4240/wjgs.123659

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Publication Name

World Journal of Gastrointestinal Surgery

ISSN

1948-9366

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Retrospective Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastrointest Surg. Oct 27, 2026; 18(10): 123659
Published online Oct 27, 2026. doi: 10.4240/wjgs.123659

Laparoscopic surgery for severe appendicitis in children: An effect and safety analysis

Zhong-Ya Xu, Hui Ye, Si-Hai Wu

Zhong-Ya Xu, Department of General Surgery, Children’s Hospital of Nanjing Medical University, Nanjing 210000, Jiangsu Province, China

Hui Ye, Si-Hai Wu, Surgical Intensive Care Unit, Children’s Hospital of Nanjing Medical University, Nanjing 210000, Jiangsu Province, China

Co-first authors: Zhong-Ya Xu and Hui Ye.

Author contributions: Xu ZY and Ye H designed the research and wrote the first manuscript as co-first authors; Xu ZY, Ye H and Wu SH contributed to conceiving the research, analyzing data, the analysis and provided guidance for the research; all authors reviewed and approved the final manuscript.

AI contribution statement: The authors declare that no AI tools were used in the development or writing of this manuscript and take full responsibility for its integrity, accuracy, and originality.

Institutional review board statement: This study was approved by the Ethic Committee of Children’s Hospital of Nanjing Medical University, No. 202604048-1.

Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.

Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.

Data sharing statement: No additional data are available.

Corresponding author: Si-Hai Wu, Surgical Intensive Care Unit, Children’s Hospital of Nanjing Medical University, No. 8 Jiangdong South Road, Jianye District, Nanjing 210000, Jiangsu Province, China. for_sea@163.com

Received: June 2, 2026
Revised: July 2, 2026
Accepted: July 17, 2026
Published online: October 27, 2026
Processing time: 130 Days and 18.3 Hours

Abstract

BACKGROUND

Severe appendicitis in children represents a critical condition that advances quickly, necessitating prompt and effective intervention to facilitate smooth postoperative recovery.

AIM

To examine the efficacy and safety of laparoscopic surgery for the treatment of severe appendicitis in pediatric patients.

METHODS

The study included 105 pediatric cases treated surgically for severe appendicitis between September 2023 and January 2026, comprising 50 cases in the control group receiving traditional open appendectomy and 55 cases in the research group undergoing laparoscopic appendectomy. Comparative analyses between the groups assessed various dimensions, including surgical metrics (operative duration, incision length, intraoperative blood loss), clinical indices (postoperative analgesic utilization rate, gastrointestinal function recovery time, length of hospital stay, hospitalization expenses), complications (inflammatory intestinal obstruction, mesenteric adhesion, intraperitoneal abscess, incision infection), inflammatory markers [interleukin (IL)-6, IL-8, C-reactive protein], stress response indicators (epinephrine, norepinephrine, cortisol), and gastrointestinal hormone levels (motilin, gastrin).

RESULTS

The findings revealed that the research group exhibited significantly lower values compared to the control group concerning operative duration, incision length, intraoperative bleeding, postoperative analgesic utilization rate, gastrointestinal function recovery time, and length of hospital stay, while hospitalization expenses remained comparable between the two groups. Additionally, lower levels of IL-6, IL-8, C-reactive protein, epinephrine, norepinephrine, and cortisol were observed in the research group, alongside elevated contents of motilin and gastrin following surgery.

CONCLUSION

Laparoscopic appendectomy demonstrates effectiveness and high clinical safety in the management of severe appendicitis in children.

Keywords: Laparoscopic surgery; Severe appendicitis in children; Effect; Safety; Retrospective analysis

Core Tip: This study assesses the effectiveness and safety of conventional open appendectomy compared to laparoscopic appendectomy in managing severe appendicitis, including gangrenous appendicitis, perforated appendicitis, and periappendiceal abscess, in children aged 6-12 years. Laparoscopic surgery yields superior clinical benefits, as evidenced by smaller incisions, shorter surgical durations, reduced intraoperative bleeding, lower requirements for postoperative analgesics, faster gastrointestinal functional recovery, and decreased length of hospital stay, all without incurring additional hospitalization costs. Furthermore, laparoscopic surgery significantly mitigates inflammation and stress responses while actively regulating postoperative gastrointestinal hormone levels.