Is laparoscopic approach still a risk factor for postappendectomy intra-abdominal abscess?

Area of Science:

• Surgical outcomes
• Gastrointestinal surgery
• Infectious disease complications

Background:

• The incidence of intra-abdominal abscess (IAA) following laparoscopic appendectomy (LA) is debated.
• Identifying risk factors for post-appendectomy IAA is crucial for patient management.

Purpose of the Study:

• To determine risk factors for post-appendectomy IAA.
• To compare the postoperative morbidity of LA versus open appendectomy.

Main Methods:

• Retrospective single-center study of 532 patients undergoing appendectomy for acute appendicitis (2015-2018).
• Analysis included demographic, clinical, and operative variables.
• Propensity score modeling (PSM) was used to compare LA and open appendectomy groups.

Main Results:

• The overall IAA rate was 6.2%.
• Independent risk factors for IAA included AAST grade ≥2, C-reactive protein >100 mg/dL, and diabetes mellitus.
• Laparoscopic appendectomy (LA) demonstrated lower postoperative morbidity and shorter hospital stay compared to open appendectomy after PSM.

Conclusions:

• Laparoscopic appendectomy (LA) is a safe and effective approach for appendicitis, not associated with increased IAA risk.
• Specific patient factors (high AAST grade, elevated CRP, diabetes) predict higher IAA risk.