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AbcApp: incidence of intra-abdominal ABsCesses following laparoscopic vs. open APPendectomy in complicated
Bobby Zamaray1,2, M F J de Boer3, Z Popal3,4
1Department of Surgery, Spaarne Gasthuis, Location Haarlem and Hoofddorp, Boerhaavelaan 22, 2035RC, Haarlem, The Netherlands. b.zamaray@amsterdamumc.nl.
Background:
Patients with complicated appendicitis are more at risk for the occurrence of postoperative intra-abdominal abscesses than patients with uncomplicated appendicitis. Studies comparing laparoscopic and open appendectomy showed limitations and contradictory findings on the incidence of intra-abdominal abscesses after appendicitis, as most of these studies analysed both uncomplicated and complicated appendicitis as one group. The aim of the present study is to investigate the incidence of intra-abdominal abscesses after laparoscopic versus open appendectomy for complicated appendicitis.
Methods:
A retrospective cohort study was performed over the period January 2009 till May 2020. All patients who had an intra-operative diagnosis of complicated appendicitis (e.g. perforation, necrosis) were included. The outcome measure was the occurrence of intra-abdominal abscesses with a postoperative follow-up of 30 days. Multivariate logistic regression analysis was performed including adjustments for significant confounders.
Results:
A total of 900 patients had undergone appendectomy for complicated appendicitis. The majority was operated laparoscopically (78%, n = 705). The incidence of postoperative intra-abdominal abscess was 12.3% in both laparoscopic and open appendectomy groups. On univariable analysis, the postoperative rates of intra-abdominal abscesses between laparoscopic and open appendectomy were not significantly different (odds ratio 1.11, 95% CI [0.67-1.84], p = 0.681).
Conclusion:
The present study provides evidence that, in current daily practice, intra-abdominal abscess formation remains a common postoperative complication for complicated appendicitis. Nonetheless, no significant difference was found with regard to intra-abdominal abscess formation when comparing laparoscopy with open surgery.
Insights
Intra-abdominal abscesses are a common complication after surgery for complicated appendicitis. This study found no significant difference in abscess rates between laparoscopic and open appendectomy procedures.
Area of Science:
- Surgical outcomes
- Gastrointestinal surgery
- Infectious complications
Background:
- Complicated appendicitis increases the risk of postoperative intra-abdominal abscesses.
- Previous studies comparing laparoscopic and open appendectomy for appendicitis had limitations, often grouping uncomplicated and complicated cases.
- The incidence of intra-abdominal abscesses post-appendectomy requires further investigation, particularly for complicated cases.
Purpose of the Study:
- To investigate the incidence of intra-abdominal abscesses after laparoscopic versus open appendectomy specifically for complicated appendicitis.
- To compare surgical outcomes between minimally invasive and traditional open approaches for complicated appendicitis.
Main Methods:
- A retrospective cohort study included 900 patients with intra-operative diagnosis of complicated appendicitis (perforation, necrosis) from January 2009 to May 2020.
- Outcome measured was the occurrence of intra-abdominal abscesses within 30 days post-operation.
- Multivariate logistic regression analysis was used, adjusting for significant confounders.
Main Results:
- The overall incidence of postoperative intra-abdominal abscess was 12.3% in both laparoscopic (78% of cases) and open appendectomy groups.
- Univariable analysis showed no significant difference in postoperative intra-abdominal abscess rates between laparoscopic and open appendectomy (OR 1.11, 95% CI [0.67-1.84], p=0.681).
Conclusions:
- Intra-abdominal abscess formation is a frequent postoperative complication in complicated appendicitis.
- Current surgical practice shows no significant difference in intra-abdominal abscess rates when comparing laparoscopy to open surgery for complicated appendicitis.
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