Pediatric surgery international · 2026
Appendiceal location in Japanese children with acute appendicitis: pelvic predominance and diagnostic and operative implications.
СтатьяНазвание и аннотация: Перевод в очереди
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Koga Shoma, Noguchi Shinichi, Kondo Tsuyoshi
Аннотация
PURPOSE: Appendiceal location may affect the diagnosis and surgical management of acute appendicitis. However, pediatric-specific data remain limited. This study evaluated appendiceal location in Japanese children with acute appendicitis and examined its clinical implications.
METHODS: In total, 105 pediatric patients who underwent laparoscopic or laparoscopic-assisted appendectomy between January 2015 and March 2024 were retrospectively reviewed. Appendiceal location was classified using a modified Wakeley classification based on intraoperative laparoscopic findings. Clinical presentation, ultrasonographic identification rate, and surgical outcomes were compared among groups.
RESULTS: The pelvic position was the most common appendiceal location (51.4%), followed by the retrocecal position (20.0%). Approximately 87.6% of patients underwent ultrasonography. The retrocecal group had a significantly lower identification rate than the other location groups (61.1% vs. 85.1%, p = 0.041). The retrocecal group had a significantly longer surgical duration than the pelvic group (median: 90 vs. 58 min, p = 0.010). The clinical presentation and postoperative complications did not differ significantly among the groups.
CONCLUSION: In this cohort of Japanese children with acute appendicitis, the pelvic position was the most common appendiceal location. The retrocecal position was associated with lower ultrasonographic identification rates and a longer surgical duration, indicating greater diagnostic and technical challenges.
METHODS: In total, 105 pediatric patients who underwent laparoscopic or laparoscopic-assisted appendectomy between January 2015 and March 2024 were retrospectively reviewed. Appendiceal location was classified using a modified Wakeley classification based on intraoperative laparoscopic findings. Clinical presentation, ultrasonographic identification rate, and surgical outcomes were compared among groups.
RESULTS: The pelvic position was the most common appendiceal location (51.4%), followed by the retrocecal position (20.0%). Approximately 87.6% of patients underwent ultrasonography. The retrocecal group had a significantly lower identification rate than the other location groups (61.1% vs. 85.1%, p = 0.041). The retrocecal group had a significantly longer surgical duration than the pelvic group (median: 90 vs. 58 min, p = 0.010). The clinical presentation and postoperative complications did not differ significantly among the groups.
CONCLUSION: In this cohort of Japanese children with acute appendicitis, the pelvic position was the most common appendiceal location. The retrocecal position was associated with lower ultrasonographic identification rates and a longer surgical duration, indicating greater diagnostic and technical challenges.