Comparative efficacy of laparoscopic and open interventions in the treatment of purulent-inflammatory diseases of abdominal organs in children
Abstract
Objective. Comparative effectiveness assessment of laparoscopic and open interventions for purulent-inflammatory diseases of abdominal organs in children. Material and methods. Treatment results of 838 patients (2017—2024) were analyzed: 706 (84.3%) underwent laparoscopic surgery, 132 (15.7%) — open surgery. Immediate results, complications according to Clavien—Dindo classification, quality of life (PedsQL 4.0), and long-term outcomes were evaluated. Stratified analysis by disease stage was performed to correct for intergroup differences. Results. Complication rate for laparoscopy was 4.2% versus 13.6% for open operations (p<0.001). Severe complications (≥IIIb) — 0.1% versus 2.3% (p=0.003). Hospital stay decreased from 6.7±2.8 to 3.2±1.4 days. In the long-term period, postoperative hernias were absent in the laparoscopy group versus 7.1% after open interventions. Quality of life was significantly higher after minimally invasive operations (94.2±5.1 versus 87.5±8.3 points). Conclusion. Laparoscopic interventions provide reduced complications, accelerated rehabilitation, and better long-term results for most forms of purulent-inflammatory diseases in children.