PMID- 25062342
OWN - NLM
STAT- MEDLINE
DCOM- 20150427
LR  - 20181202
IS  - 1557-9034 (Electronic)
IS  - 1092-6429 (Linking)
VI  - 24
IP  - 8
DP  - 2014 Aug
TI  - Cosmetic outcomes following appendectomy in children: a comparison of surgical 
      techniques.
PG  - 584-8
LID - 10.1089/lap.2014.0061 [doi]
AB  - BACKGROUND: Although cosmetic superiority is widely stated as an advantage of 
      single-incision laparoscopy, there are limited studies looking at cosmetic 
      outcome. We sought to determine patients' cosmetic satisfaction after undergoing 
      appendectomy by the single-incision laparoscopic appendectomy (SILA), multiport 
      laparoscopic appendectomy (LA), or open appendectomy (OA) procedure. PATIENTS AND 
      METHODS: Five hundred eighty pediatric patients who underwent appendectomy at a 
      single institution between February 2010 and July 2011 were identified and asked 
      to complete the Patient Scar Assessment Scale (PSAS), a validated evaluation tool 
      for linear scars. In addition, patients were asked the "Ultimate Question" (UQ), 
      which correlates with a patient's overall satisfaction. Linear regression models 
      were used to examine differences between surgical approaches with statistical 
      significance set at P<.05. Covariates for all models included patient 
      demographics, length of stay, and surgeon. RESULTS: In total, 212 surveys were 
      returned (SILA, 122; LA, 41; OA, 49) for a response rate of 37%. Regression 
      models demonstrated significantly higher mean total PSAS scores for patients who 
      underwent SILA and laparoscopic appendectomy (LA) appendectomy procedures 
      compared with the open procedure (SILA, 8.70; LA, 8.86; OA, 8.01; beta=-0.21, 
      P<.05). Patients who experienced the SILA and LA procedures reported 
      significantly higher mean UQ scores compared with OA (SILA, 9.79; LA, 9.75; OA, 
      9.39; beta=-0.22, P<.05). SILA patients reported a 10 on the UQ significantly more 
      often (91.1%) compared with either LA (81%) or OA (75.5%) (P<.05). CONCLUSIONS: 
      SILA or LA appendectomy was associated with significantly increased cosmetic 
      satisfaction by patients and their families when compared with OA. This is the 
      first study to show that pediatric patients value attempts to minimize scarring 
      with laparoscopic surgery. Further studies are needed to determine if specific 
      patient factors influence satisfaction with scars.
FAU - Chandler, Nicole M
AU  - Chandler NM
AD  - 1 Division of Pediatric Surgery, All Children's Hospital/The Johns Hopkins School 
      of Medicine , St. Petersburg, Florida.
FAU - Ghazarian, Sharon R
AU  - Ghazarian SR
FAU - King, Tracy M
AU  - King TM
FAU - Danielson, Paul D
AU  - Danielson PD
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Laparoendosc Adv Surg Tech A
JT  - Journal of laparoendoscopic & advanced surgical techniques. Part A
JID - 9706293
SB  - IM
MH  - Adolescent
MH  - Appendectomy/adverse effects/*methods
MH  - Appendicitis/*surgery
MH  - Child
MH  - Child, Preschool
MH  - Cicatrix/etiology/*prevention & control
MH  - Esthetics
MH  - Female
MH  - Humans
MH  - Infant
MH  - Infant, Newborn
MH  - Laparoscopy/*methods
MH  - Length of Stay
MH  - Male
MH  - *Patient Satisfaction
MH  - Population Surveillance
MH  - Regression Analysis
MH  - Retrospective Studies
MH  - Surgery, Plastic/*methods
MH  - Surveys and Questionnaires
MH  - Treatment Outcome
EDAT- 2014/07/26 06:00
MHDA- 2015/04/29 06:00
CRDT- 2014/07/26 06:00
PHST- 2014/07/26 06:00 [entrez]
PHST- 2014/07/26 06:00 [pubmed]
PHST- 2015/04/29 06:00 [medline]
AID - 10.1089/lap.2014.0061 [doi]
PST - ppublish
SO  - J Laparoendosc Adv Surg Tech A. 2014 Aug;24(8):584-8. doi: 10.1089/lap.2014.0061.