Study was designed in order to evaluate the discrepancies between surgical and histological
diagnosis in pediatric acute appendicitis (AA) and to compare the outcomes of laparoscopic
(LA) and open appendectomies (OA).In a retrospective observational cohort, AA patients
were included under 18 years of age, operated between 2011 and 2020. Surgical diagnosis
was defined by the operating surgeon. The histological findings were classified as
uncomplicated and complicated AA. The LOS and complications were also statistically
analyzed.Altogether, 1444 patients were included. Significant strong correlation and
a moderate to substantial agreement were found between the surgeon's and the histopathological
findings in all appendectomy cases (weighted kappa value in OA: 0.633, LA: 0.639,
total sample: 0.637). If the surgeon's diagnosis was less severe than the pathologist's,
the LOS was 4 (3;7) days, whereas if the surgical diagnosis was correct, the LOS was
3 (3;5) days (p < 0.0001).In contrary to the literature, our study revealed a strong
correlation and moderate agreement between the intraoperative and histopathological
findings regarding the severity of AA. Complicated cases are distinctly recognizable
during the surgery. In case the surgeon underestimates the severity of AA, the chance
of complications is higher.II.
