{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T03:33:34Z","timestamp":1768448014333,"version":"3.49.0"},"reference-count":0,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Klin Padiatr"],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\nBackground  Transumbilical laparoscopic-assisted appendectomy (TULAA) is fast and cost-effective since no endoloops, staplers or wound protection devices are used. We analyzed the effects of TULAA as first approach for perforated (PA) and non-perforated (NPA) appendicitis in children.<\/jats:p><jats:p>\nPatients  We performed a retrospective analysis of 181 children for whom TULAA was the first approach for appendicitis between October 2010 and March 2016. <\/jats:p><jats:p>\nMethods Morbidity, additional laparoscopic instrument insertion (AI), conversions to open extraumbilical appendectomy (OC), and complications were evaluated.<\/jats:p><jats:p>\nResults TULAA was initiated in 181 (87.4%) children (113 boys: 68 girls). Median age was 10.3 years (3.3\u201313.9 years) and BMI 16.8\u2009kg\/m2 (12.4\u201330.8). Appendicitis was non-perforated in 157 (86.7%) and perforated in 24 (13.3%) patients. TULAA was finalized in 142 (78.5%) patients, AI were inserted in 20 (11%) and OC were performed in 19 (10.5%) patients. Duration of surgery did not exceed 20\u2009min for 12.8%, and 30\u2009min for 43.6% of patients with TULAA and NPA. The rate of wound infections did not differ between procedures (TULAA 3\/142 (2.1%), AI 0 (0%), OC 1\/19 (5.3%), P=1.000). Further postoperative course was uneventful in 179 (98.9%) patients.<\/jats:p><jats:p>\nConclusion  TULAA can be used as first approach for appendicitis in all children with a low rate of complications. Extracorporeal appendix stump closure can be safely achieved in the majority of children without using laparoscopic disposable devices.<\/jats:p>","DOI":"10.1055\/s-0044-101622","type":"journal-article","created":{"date-parts":[[2018,3,15]],"date-time":"2018-03-15T23:40:40Z","timestamp":1521157240000},"page":"194-199","source":"Crossref","is-referenced-by-count":3,"title":["Update on Transumbilical Single-Incision Laparoscopic Assisted Appendectomy (TULAA) \u2013 Which Children Benefit and What are the Complications?"],"prefix":"10.1055","volume":"230","author":[{"given":"Martin","family":"D\u00fcbbers","sequence":"additional","affiliation":[{"name":"Division of Pediatric Surgery, University Hospital Cologne, K\u00f6ln, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Nikolaou","sequence":"additional","affiliation":[{"name":"Division of Pediatric Surgery, University Hospital Cologne, K\u00f6ln, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hans","family":"Fuchs","sequence":"additional","affiliation":[{"name":"Department of General, Visceral and Cancer Surgery, University Hospital Cologne, K\u00f6ln, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janina","family":"Fischer","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Adolescent Medicine, University Hospital of Cologne, K\u00f6ln, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hakan","family":"Alakus","sequence":"additional","affiliation":[{"name":"Department of General, Visceral and Cancer Surgery, University Hospital Cologne, K\u00f6ln, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica","family":"Leers","sequence":"additional","affiliation":[{"name":"Department of General, Visceral and Cancer Surgery, University Hospital Cologne, K\u00f6ln, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christiane","family":"Bruns","sequence":"additional","affiliation":[{"name":"Department of General, Visceral and Cancer Surgery, University Hospital Cologne, K\u00f6ln, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grigore","family":"Cernaianu","sequence":"additional","affiliation":[{"name":"Division of Pediatric Surgery, University Hospital Cologne, K\u00f6ln, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2018,3,15]]},"container-title":["Klinische P\u00e4diatrie"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0044-101622.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2018,7,11]],"date-time":"2018-07-11T22:57:33Z","timestamp":1531349853000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0044-101622"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,3,15]]},"references-count":0,"journal-issue":{"issue":"04","published-online":{"date-parts":[[2018,7,11]]},"published-print":{"date-parts":[[2018,7]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0044-101622","relation":{},"ISSN":["0300-8630","1439-3824"],"issn-type":[{"value":"0300-8630","type":"print"},{"value":"1439-3824","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,3,15]]}}}