The Clinical Analysis Of Postoperative Complications Of 319 Cases In Pediatric Perforated Appendicitis

Objective: To investigate the postoperative complications in pediatric perforated appendicitis and provide an improved basis for clinical diagnosis and treatment.Methods: The clinical data of all patients with pediatric perforated appendicitis who underwent open appendectomy and laparoscopic appendectomy in Shenzhen Children's Hospital between January 1,2013 and December 31,2016 were retrospectively analyzed.Patients' clinical data included clinical features and laboratory test results,intraoperative findings and postoperative complications,etc.The postoperative complications were classified according to the Clavien-Dindo classification criteria.The risk factors of postoperative complications of grade ? and above were analyzed by multivariate Logistic regression analysis.Results: During the observation period,a total of 1599 pediatric patients were operated for appendicitis in Shenzhen Children's Hospital.319 patients with a perforated appendicitis(PA)(meanage 7.0 ± 2.1 years)met the inclusion criteria for this study.Laparoscopic appendectomy was performed in 209 children and open appendectomy was in 110 children.The incidence of postoperative complications was 26.1%.Postoperative complications were peritoneal abscess,retention of urine,wound infection,intestinal obstruction,wound dehiscence and wound bleeding.According to the Clavien-Dindo classification,the incidence of postoperative complication of grade?,?,? were 7.8%,3.4%,14.7%,respectively.No complications of grade ? and ? were observed.58(18.1%)patients developed postoperative complications,which were peritoneal abscess,wound infection,intestinal obstruction,wound dehiscence and required complication-related intervention.Multivariate Logistic regression analysis showed that C reactive protein values at admission(OR=1.381,95%CI:1.15~1.657)is the risk factor of postoperative complications of grade II and above in children with perforated appendicitis.(P<0.05)Conclusion:1.The results of this study reveal that postoperative complications of pediatric perforated appendicitis are peritoneal abscess,retention of urine,wound infection,intestinal obstruction,wound dehiscence and wound bleeding.The tatal incidence is 26.1%.The incidence of postoperative complications of grade?and above which are peritoneal abscess,wound infection,intestinal obstruction and wound dehiscence is 18.1%.2.CRP value is a related risk factor of PA postoperative complications of grade ? and above.The higher the CRP value is,the more likely the postoperative complication occur.