Clinical Value of Visual endoscopic retrograde appendicitis therapy in Pediatric Appendicitis

Objectives Explore the Clinical Value of Visual endoscopic retrograde appendicitis therapy in Pediatric Appendicitis. Methods Analysis of clinical data from 38 pediatric patients who underwent Visual endoscopic retrograde appendicitis therapy (V-ERAT) for appendicitis at Shenzhen Children's Hospital's Hepatobiliary and Oncology Surgery Department between December 2023 and April 2025. The study evaluated V-ERAT success rates, operative times, first-hospitalization appendectomy rate, and recurrence rate to evaluate the safety and efficacy of this procedure. Results All 38 patients underwent V-ERAT, with a surgical success rate of 92.11%. Three pediatric patients underwent laparoscopic appendectomy during their initial hospitalization, yielding an appendectomy rate of 7.89% during the first admission. The median operative time was 75 (55, 101) minutes. Thirty-three cases (94.29%) achieved a Numerical Rating Scale score < 3 at 6 hours postoperatively. No V-ERAT related complications occurred. Among the 34 patients followed up, 6 experienced recurrence, yielding a recurrence rate of 17.14%. Conclusions V-ERAT for pediatric appendicitis is a novel minimally invasive technique integrating diagnosis and treatment while preserving the appendix. It demonstrates promising preliminary efficacy and operates with high safety and reliability without requiring X-ray or ultrasound guidance. This approach features no external surgical incisions and facilitates rapid postoperative recovery, aligning with the principles of enhanced recovery after surgery (ERAS).