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Intraabdominal abscesses following laparoscopic and open appendectomies
E Tang1, A E Ortega, G J Anthone
1Department of Surgery, University of Southern California School of Medicine, Los Angeles 90033, USA.
Surgical Endoscopy
|March 1, 1996
Summary
Laparoscopic and open appendectomies showed similar rates of postoperative abscesses for acute and gangrenous appendicitis. However, perforated appendicitis cases suggest a higher abscess risk with laparoscopic procedures, warranting further investigation.
Area of Science:
- Surgical outcomes
- Minimally invasive surgery
- Gastrointestinal surgery
Background:
- Postoperative intraabdominal abscess formation is a potential complication of appendectomy.
- Comparing laparoscopic and open approaches is crucial for patient safety.
Purpose of the Study:
- To evaluate and compare the incidence of postoperative intraabdominal abscesses after laparoscopic versus open appendectomies.
- To analyze outcomes based on the severity of appendicitis (acute, gangrenous, perforated).
Main Methods:
- Retrospective review of 1,287 appendectomies (January 1993 - July 1994).
- Exclusion of cases converted from laparoscopic to open procedures.
- Categorization of appendicitis into acute (45%), gangrenous (9%), and perforated (46%) based on intraoperative diagnosis.
Main Results:
- No significant difference in abscess rates for acute or gangrenous appendicitis between laparoscopic and open approaches.
- For perforated appendicitis, laparoscopic procedures showed a trend toward higher abscess rates (11% vs. 2.9%, P=0.054).
- Postoperative stay was similar for both methods (6.3 days open vs. 6.1 days laparoscopic).
Conclusions:
- Laparoscopic and open appendectomies have comparable safety profiles for acute and gangrenous appendicitis regarding abscess formation.
- Laparoscopic appendectomy for perforated appendicitis may be associated with an increased risk of intraabdominal abscesses.
- Further prospective studies are recommended to scrutinize laparoscopic appendectomy outcomes in perforated appendicitis cases.