Evolución clínica y estancia hospitalaria postquirúrgica en apendicitis complicada según la técnica quirúrgica : laparoscopia vs laparotomía atendidos durante el año 2024 al año 2025, en el Hospital Francisco Icaza Bustamante.

Abstract

Introducton: Appendicitis is one of the leading causes of emergency pediatric surgery, usually presenting as perforated appendicitis or peritonitis as a consequence of delayed diagnosis. In Guayaquil, the choice between laparotomy and laparoscopy is greatly influenced by the complexity of the case and the hospital infrastructure, since laparoscopy is less invasive, unlike laparostomy, which is open surgery used in highly complex scenarios but with limited resources. Objective: To evaluate and compare the clinical course and postoperative hospital stay in pediatric patients who underwent laparoscopic and laparotomy appendectomy at the Francisco Icaza Bustamante Hospital during 2024 and 2025. Methods: A comparative, descriptive, and cross-sectional study with a quantitative approach was conducted, analyzing the surgical technique and various postoperative complications, including pain levels and length of hospital stay. Results: This research revealed a statistically significant relationship between the surgical technique and postoperative clinical course (χ² = 372; p < 0.001). Similarly, a significant relationship was found between the technique and the length of postoperative hospital stay (χ² = 192; p < 0.001). The surgical selection approach is not irrelevant but rather an important factor that can directly impact patient recovery and subsequent clinical outcomes. Conclusion: Pediatric patients who undergo laparoscopic surgery generally have a better clinical outcome and a shorter hospital stay compared to those who opt for open surgery. However, these benefits are not solely attributable to the surgical technique, as the severity of the clinical presentation and the stage of the disease have a more significant and decisive impact on the outcome.