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Irrigation Versus Suction in Laparoscopic Appendectomy for Complicated Appendicitis: A Meta-analysis.
Charalampos Siotos1, Konstantinos Stergios2, Vishnu Prasath3
1Department of Surgery, Johns Hopkins University, Baltimore, Maryland; Laboratory of Experimental Surgery and Surgical Research N.S. Christeas, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
Irrigation during laparoscopic appendectomy does not prevent intra-abdominal abscesses (IAA). This meta-analysis found no significant difference in IAA rates between irrigation and suction alone for complicated appendicitis.
Area of Science:
- Surgical Emergencies
- Minimally Invasive Surgery
- Evidence-Based Medicine
Background:
- Acute appendicitis is a common surgical emergency.
- Intra-abdominal abscesses (IAA) are a significant complication.
- The role of irrigation in preventing IAA after appendectomy is debated.
Purpose of the Study:
- To investigate the evidence on irrigation versus suction alone for IAA development.
- To analyze IAA rates after laparoscopic appendectomy for complicated appendicitis.
Main Methods:
- Systematic review and meta-analysis of five studies.
- Searched PubMed, Scopus, Embase, Cochrane, and Web of Science.
- Analyzed postoperative IAA rates using a random-effects model.
Main Results:
- Overall irrigation did not significantly increase IAA rates (OR=2.39).
- Adults showed nonsignificant lower IAA odds with irrigation (OR=0.42).
- Pediatric patients showed nonsignificant higher IAA risk with irrigation (OR=2.98), and irrigation added ~7 minutes to operation time.
Conclusions:
- Irrigation during laparoscopic appendectomy does not appear to prevent IAA in adults or pediatric patients.
- The practice does not impact postoperative length of stay.
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