Laparoscopic Appendectomy: Risk Factors for Postoperative Intraabdominal Abscess

Area of Science:

• Minimally Invasive Surgery
• Surgical Outcomes Research
• Gastrointestinal Surgery

Background:

• Laparoscopic appendectomy (LA) is widely adopted but associated with a potential increase in intra-abdominal abscess (IAA) rates compared to open surgery.
• Postoperative IAA significantly increases patient morbidity, necessitating identification of predictive factors.
• Understanding risk factors for IAA after LA is crucial for developing preventative strategies.

Purpose of the Study:

• To identify preoperative and intraoperative risk factors associated with the development of intra-abdominal abscess (IAA) following laparoscopic appendectomy (LA).

Main Methods:

• Retrospective review of 1300 consecutive laparoscopic appendectomy cases from January 2005 to June 2015.
• Analysis of demographic, clinical, and intraoperative variables.
• Logistic regression analysis to determine independent risk factors for postoperative IAA.

Main Results:

• A total of 1300 LA procedures were performed, with 2.3% resulting in postoperative IAA.
• Multivariate analysis identified obesity (BMI >30), leukocytosis >20,000/mm³, perforated appendicitis, and operative time >90 minutes as significant risk factors for IAA.
• No mortality was observed in the study cohort.

Conclusions:

• Obesity, elevated white blood cell count, perforated appendicitis, and prolonged operative time (>90 minutes) are associated with a higher incidence of IAA after LA.
• Close postoperative surveillance is recommended for patients with these risk factors to facilitate early detection and management of IAA.