Utilization of a specimen retrieval bag during laparoscopic appendectomy for both uncomplicated and complicated...

Area of Science:

• Surgical innovation and patient outcomes
• Infectious disease prevention in surgery

Background:

• Surgical site infections (SSIs) are a significant complication following appendectomy.
• Laparoscopic appendectomy is a common procedure for appendicitis.
• The use of specimen retrieval bags aims to minimize intra-abdominal contamination during laparoscopic surgery.

Purpose of the Study:

• To investigate the association between using a retrieval bag during laparoscopic appendectomy and the rate of postoperative surgical site infections.
• To evaluate this association in both uncomplicated and complicated appendicitis cases (perforation/abscess).

Main Methods:

• Analysis of 10,357 patients from the 2016 Appendectomy-Targeted American College of Surgeons National Surgical Quality Improvement Program database.
• Comparison of 30-day postoperative surgical site infection rates between patients who had the appendix removed with a retrieval bag versus those who did not.
• Logistic regression analysis adjusted for patient and disease variables.

Main Results:

• A retrieval bag was used in 92.6% of cases.
• The 30-day SSI rate was 3.6% with bag use and 4.2% without bag use.
• No statistically significant association was found between retrieval bag utilization and SSI rates (adjusted odds ratio 1.15, P = .49), even in patients with perforated appendicitis.

Conclusions:

• Intraoperative use of a retrieval bag during laparoscopic appendectomy is not associated with a significant reduction in postoperative surgical site infections.
• This conclusion holds true for both uncomplicated and complicated appendicitis.
• Current evidence does not support routine use of retrieval bags solely for SSI prevention in laparoscopic appendectomy.