Comparison of Neuroendocrine Responses in Open and Laparoscopic Appendectomies in Children: A Randomized Controlled Trial

Aim: To compare the neuroendocrine changes and responses to surgical stress in open and laparoscopic appendectomy techniques in children. Materials and Methods: Sixty-seven patients aged between six and 14 years presented to the pediatric surgery clinic between July and September 2008 with acute abdominal pain and were enrolled into this study. Patients had class I-II disease, according to the American Society of Anesthesiology, and were scheduled for open and laparoscopic appendectomies. The patients were randomly divided into two groups according to the method of appendectomy used. The neuroendocrine responses of both groups were then compared. Results: No statistical difference was observed between the open and laparoscopic appendectomy groups in terms of age, gender, weight, or duration of surgery (p> 0.05). In addition, no statistical difference was observed between the mean arterial pressure ( MAP), cardiac apex beat (CAB), peripheral oxygen saturation ( SpO(2)), and end tidal carbon dioxide pressure (ETCO2) values of the open and laparoscopic appendectomy groups at 0, 5, 10, 15, 30, 60 minutes, and at the end of the operation ( p> 0.05). There was no statistical difference between the mean values of MAP, CAB, SpO2, or ETCO2 of the groups at the end of the operation and at 1, 2, 3, 12, and 24 hours postoperatively ( p> 0.05) or between the mean glucose, prolactin, or cortisol levels of the two groups at 0 and 30 minutes and at the end of the operation ( p> 0.05). Conclusions: This study demonstrated that neuroendocrine responses to surgical stress were similar in open and laparoscopic appendectomy operations in children. No significant difference was found between the responses developed in either group.