Comparison of the effectiveness of treatment of acute phlegmonous appendicitis and its complications in children using laparoscopic technologies depending on the technical generation of the equipment

Acute appendicitis has been and remains the most common pathology in emergency pediatric surgery. Treatment technologies are constantly improving, but the availability of different generations of laparoscopic equipment in medical facilities requires the development of recommendations for use. Аim - to evaluate the effectiveness and safety of laparoscopic interventions among children with acute phlegmonous appendicitis and its complications, performed using laparoscopic equipment of different technological generations (first and second generations of minimally invasive equipment) by analyzing key clinical, intraoperative, and postoperative indicators. Materials and methods. The analysis covered 61 cases of children diagnosed with acute phlegmonous appendicitis who underwent laparoscopic appendectomy between 2015 and 2023. The patients were divided into two groups: I - 33 children who underwent surgery using first-generation laparoscopic equipment (with analog imaging and instruments with limited functionality) (archival data from medical records for 2015-2017); II - 29 children who underwent surgery using second-generation laparoscopic equipment (with digital imaging and instruments with an expanded range of capabilities) (archival data from medical records for 2022-2023). To evaluate the effectiveness of treatment, an analysis of clinical and laboratory indicators was performed, including the duration of surgery, length of hospital stays, number of medications required for infusion and symptomatic therapy, and number and duration of antibiotic treatments. Results. Comparing the treatment results, the following can be noted for patients in the group II: the duration of surgery was shorter; required less infusion therapy; had a shorter hospital stay; normalization of blood laboratory parameters occurred faster, despite the shorter hospital stay. Conclusions. The results of surgical treatment are directly dependent on the technical generation of equipment. Considering the heterogeneity of medical equipment in Ukrainian medical institutions, the question of choosing a treatment method and tactics depending on the technical generation of equipment remains relevant. The study was conducted in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Bioethics Committee of the mentioned institution. Informed consent was obtained from all participants. No conflict of interest was declared by the authors.