Transumbilical single-port appendectomy in children: a retrospective study

OBJECTIVE: Acute appendicitis is the leading cause of abdominal surgery. This study evaluated outcomes of transumbilical single-incision laparoscopic appendectomy (TSILA) compared with conventional laparoscopy and open surgery. METHODS: A retrospective study of 550 pediatric patients (0-18 years) undergoing an appendectomy (2020-2023) at a tertiary center was conducted. Patients were stratified by technique and appendicitis grade (I-IV). Data were analyzed using Pearson's Chi-squared and ANOVA tests (p < 0.05). RESULTS: TSILA accounted for 34.5% of cases (n = 190) and showed shorter hospital stays (2.98 days) compared to conventional laparoscopy (4.23 days) and open surgery (5.58 days) (p < 0.001). Postoperative fever was lower with TSILA (7.9%) compared to conventional laparoscopy (12.7%) and open surgery (27.5%) (p < 0.0001). Wound infection rates were similar between TSILA and conventional laparoscopy, both lower than open surgery. Postoperative antibiotic use was lowest with TSILA (p < 0.0001). In Grade IV, TSILA showed shorter hospital stay, with no significant differences in complications or antibiotic use. CONCLUSIONS: TSILA is a safe option, associated with shorter hospital stays and reduced antibiotic use in Grades I-III. In advanced cases, benefits were limited to shorter hospitalization, with outcomes comparable to conventional techniques.