Irrigation Versus Suction Alone During Laparoscopic Appendectomy for Uncomplicated Acute Appendicitis

Area of Science:

• Laparoscopic surgery
• Surgical outcomes
• Infectious disease

Background:

• Acute appendicitis is a common surgical emergency.
• Laparoscopic appendectomy is the standard treatment for uncomplicated acute appendicitis.
• The role of peritoneal irrigation versus suction alone during the procedure is debated.

Purpose of the Study:

• To compare surgical outcomes of peritoneal irrigation versus suction alone during laparoscopic appendectomy.
• To identify risk factors for surgical site infection (SSI) in patients with uncomplicated acute appendicitis.

Main Methods:

• Retrospective review of patients with uncomplicated acute appendicitis (January 2014-March 2016).
• Comparison of irrigation and suction alone groups based on postoperative complications, hospital stay, operation time, and antibiotic duration.
• Logistic regression analysis to identify SSI risk factors.

Main Results:

• 553 patients analyzed; 207 (37.4%) received irrigation, 346 (62.6%) received suction alone.
• Irrigation group had higher preoperative fever rates and longer operative times (P=0.027).
• Postoperative complication rate was significantly higher in the irrigation group (12.6% vs 4.5%, P=0.001).

Conclusions:

• Peritoneal irrigation provides no advantage over suction alone in laparoscopic appendectomy for uncomplicated appendicitis.
• Irrigation may increase operative time and the risk of surgical site infection.
• Preoperative fever and irrigation are identified as risk factors for SSI.