Postoperative Pneumoperitoneum in Pediatric Patients : Residual Air or Surgical Complication? A Prospective Study

Background: Residual postoperative pneumoperitoneum (RPP) can be confused with postoperative complications. Our aim was to study RPP characteristics in pediatric patients. Materials and Methods: Prospective study in children with noncomplicated appendicitis, from July to December 2019, divided into open appendectomy (OA) or laparoscopic appendectomy (LA). Abdominal ultrasounds were performed daily to assess RPP. Demographic, surgical data, and RPP characteristics were analyzed. Results: Forty-one patients (63% male) aged 9.8 ± 2.9 years were included: 19 had OA and 22 LA. RPP was present in 90.9% of LA patients versus 21.1% of OA (P < .001). RPP disappeared by the postoperative day (POD) 2, in all OA patients. RPP was present in 90.9% of LA patients in POD 1, 53.8% on POD 2, 25% on POD 3, and in no patient from POD 4. RPP prevalence was not associated with surgical duration, age, gender, or type of appendicitis. RPP was associated with pain radiating to the shoulders (PRS) (P = .018), with a sensitivity of 50.0% and specificity of 88.23% for diagnosis. Conclusions: Surgical approach was the main factor associated with RPP persistence. PRS in the physical examination may be helpful for diagnosis when RPP is suspected. The persistence of RPP beyond POD 4 is uncommon, and should be considered when making decisions.

Medienart:

E-Artikel

Erscheinungsjahr:

2022

Erschienen:

2022

Enthalten in:

Zur Gesamtaufnahme - volume:32

Enthalten in:

Journal of laparoendoscopic & advanced surgical techniques. Part A - 32(2022), 5 vom: 28. Mai, Seite 576-582

Sprache:

Englisch

Beteiligte Personen:

Muñoz-Serrano, Antonio Jesús [VerfasserIn]
Delgado-Miguel, Carlos [VerfasserIn]
Velayos, María [VerfasserIn]
Estefanía-Fernández, Karla [VerfasserIn]
Barrena Delfa, Saturnino [VerfasserIn]
Bret Zurita, Montserrat [VerfasserIn]
Hernández, Francisco [VerfasserIn]
Martínez, Leopoldo [VerfasserIn]

Links:

Volltext

Themen:

Journal Article
Laparoscopy
Pediatrics
Pneumoperitoneum
Postoperative complications
Ultrasonography

Anmerkungen:

Date Completed 17.05.2022

Date Revised 17.05.2022

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1089/lap.2021.0680

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM338794360