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Introduction: Acute appendicitis is one of the most common indications for urgent surgical intervention in children. An open appendectomy has been applying since the end of the XIX century, but for the last thirty years, laparoscopic appendectomy became an alternative. There is no consensus among surgeons, which method is suitable for pediatric patients. Aim: The aim of the research is to establish which of these two methods has therapeutic advantages in children, analyzing comparatively their operative and postoperative course in the treatment of acute appendicitis. Material and methods: The study includes 330 children with acute appendicitis. Patients were divided into 2 groups: operated by the method of open appendectomy (OA) and laparoscopic surgery (LA). Analyzed parameters were: methods of operation, age and sex of patients, intraoperative findings, duration of surgery, length of hospital stay, intraoperative and postoperative complications, preoperative levels of leukocytes, duration of antibiotic therapy and pain therapy. Results: In total of 330 children with acute appendicitis, 255 (77%) were operated by OA and 75 (23%) by LA. Catarrhal appendicitis is significantly more frequent intraoperative finding in LA (61%, p < 0.05), while phlegmonous is in OA (49%, p < 0.05). Mean operative time is 61 minutes in LA, compared with 38 minutes in OA. Mean length of hospital stay is 4.2 days after both operative techniques. Antibiotic treatment lasts as the hospital stay. Mean length of pain treatment is 1.3 days after LA and 1.5 days after OA. Conclusion: More children and especially with severe forms of acute appendicitis were treated by OA. Lesser number of patients and less severe forms of acute appendicitis were treated by LA. Total length of hospital stay, antibiotic and pain therapy are shorter in laparoscopic comparing to OA.

Introduction: Acute appendicitis is the most common indication for abdominal surgery in children. Despite the increase of obesity in children, little data exist that examine the impact of obesity on surgical outcomes in children. Laparoscopic appendectomy has become more popular and it is used more often in treating obese children. Aim: The aim of this study is to evaluate the impact of obesity on operative and postoperative recovery of children with acute appendicitis, treated with open and laparoscopic method, and to determine which of these techniques is superior. Material and methods: We analyzed medical reports of children treated for acute appendicitis. This study included 330 patients. We used age percentile tables for weight and defined child obesity as weight at or above 90th percentile. Both obese and non-obese patients were divided into two groups: patients who underwent open surgery (OA), and those who underwent laparoscopic surgery (LA). We analyzed gender and age of our patients, their operative time, hospital stay, leukocytes count and complication rate. Results: The study includes 330 patients treated for acute appendicitis. There were 69 obese children (21%). The open technique was more often used in treating both obese (84%) and non-obese patients (76%). Obesity has been shown to increase operative time and hospital stay with no statistical significance, but with significantly higher incidence of complications after OA (67%) than after LA (33%). In the group of non-obese children, there was also significantly higher incidence of complications after OA (91%) than after LA (9%). Conclusion: According to observed parameters, obesity in our patients has no significant impact on the outcome of appendectomy in children. Concerning that there is no significantly high incidence of total number of complications referring to OA, laparoscopic technique should be recommended in treating all stages of acute appendicitis, both in obese and non-obese children.