Laparoscopic Lavage Versus Aspiration Alone in Perforated Acute Appendicitis: A Prospective Randomized Controlled...

Area of Science:

• Surgery
• Gastroenterology
• Infectious Disease

Background:

• Perforated appendicitis often leads to periappendicular collections or abscesses.
• The optimal management strategy for these collections remains a subject of debate.
• Preventing postoperative complications is a key goal in treating perforated appendicitis.

Purpose of the Study:

• To compare the efficacy of simple aspiration versus lavage followed by aspiration for periappendicular collections in perforated appendicitis.
• To determine the impact of each method on postoperative complications, morbidity, and mortality.

Main Methods:

• A comparative study involving 286 patients with perforated appendicitis.
• Group I: Aspiration of periappendicular collections without prior lavage.
• Group II: Lavage with 500 mL saline followed by aspiration.

Main Results:

• No significant differences were observed between the groups regarding age, sex, hospitalization duration, or complication rates.
• Both methods showed comparable rates of abscess formation, morbidity, and mortality.
• Postoperative complications were not significantly reduced by the addition of lavage prior to aspiration.

Conclusions:

• Simple aspiration of the surgical area without prior lavage is a sufficient and safe method for managing periappendicular collections in perforated appendicitis.
• This finding suggests a potentially simpler and more efficient approach to treatment.
• The study supports aspiration as a standalone method, potentially reducing procedure time and resource utilization.