Background: The aim of the study was to describe the technique of two-trocar laparoscopic appendectomy and\ncompare the outcome between two- and three-trocar techniques in children.\nMethods: All children who underwent laparoscopic surgery for suspected appendicitis from 2006 to 2014 in a\ncenter for pediatric surgery were included in the study. Converted surgeries and patients with appendiceal abscess\nor concomitant intestinal obstruction were excluded. A total of 259 children underwent appendectomy with either\ntwo (35 %) or three (65 %) laparoscopic trocars according to the surgeonsââ?¬â?¢ preference and intraoperative judgment.\nPatient demographics, clinical symptoms, surgery characteristics, and complications were reviewed.\nResults: The mean age of the children was 10.4 years (range, 1ââ?¬â??14 years). The mean follow-up time was 41.2 months\n(SD Ã?± 29.2). No significant differences in age, gender, weight, or signs and symptoms were found between the twoand\nthree-trocar groups. The mean surgery time was significantly shorter in the two-trocar group (47 min) than in the\nthree-trocar group (66 min; p < 0.001). The rates of surgical complications were 2 % vs. 4 %, (p = 0.501), and the rates of\npostoperative complications were 0 % vs. 5 % (p = 0.054), in the two- and three-trocar groups. The overall incidence of\npostoperative wound infection was low (<1 %) and did not differ between groups.\nConclusions: Two-trocar laparoscopic appendectomy seems to be a safe and feasible technique with a low rate of\npostoperative wound infections. The present findings demonstrate that when the two-trocar technique could be\napplied, it is a good complement to the conventional three-trocar technique.
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