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A simple scoring system to reduce intraabdominal septic complications after laparoscopic appendectomy
A Serralta1, M Planells, J Bueno
1Servicio de Cirugía General y del Aparato Digestivo II, Hospital Universitario "La Fe", Avda Campanar 21, 46009 Valencia, Spain.
Background:
The development of intraabdominal abscess (IAA) following laparoscopic appendectomy (LA) is associated with significant morbidity. The aim of the present study was to validate an IAA risk score constructed from a previous review of 156 consecutive LA.
Methods:
The score was tested in 250 subsequent consecutive LA and in patients with a positive risk score. Broad-spectrum antibiotics were administered in order to avoid IAA.
Results:
Factors related to IAA included clinically complicated appendicitis, leucocytosis >15,000/microl, a difference of >1 degrees C between axillary and rectal temperature, intraoperative findings such as (gangrenes and perforation), and intraoperative perforation of the appendix. In this series, broad-spectrum antibiotic therapy in patients with a positive IAA risk score reduced the incidence of IAA from 7.05% to 1.60%.
Conclusion:
This policy of identifying high-risk patient via the scoring system and instituting subsequent antibiotic therapy in patients at risk reduces the incidence of IAA following LA.