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Invited Critique |

Laparoscopic Appendectomy in Children—Invited Critique

Anne C. Fischer, MD, PhD
Arch Surg. 2007;142(1):62. doi:10.1001/archsurg.142.1.62.
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In this era of evidence-driven best practices, the cost analysis by Lukish and colleagues of 2 LA methods is a timely and innovative study that addresses the higher costs typically associated with laparoscopy. A meta-analysis1 of 54 controlled trials did find that laparoscopy afforded a reduction in postoperative pain, decreased LOS, earlier return to normal activities, and fewer wound infections, with the caveat of increased ST. The pediatric trials likewise did not differ from adult trials in these outcomes. Thus, the argument for the cost-effectiveness of laparoscopy is that the decreased LOS offsets the increased costs incurred by nonreusable instrumentation and increased ST.2,3

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