Intra-abdominal abscesses following laparoscopic and open appendectomies

Area of Science:

• Surgical Outcomes
• Infectious Complications
• Minimally Invasive Surgery

Background:

• Previous studies suggest a trend of increased infectious complications after laparoscopic appendectomy.
• Intra-abdominal abscess formation is a significant post-appendectomy complication.

Purpose of the Study:

• To compare the incidence of post-appendectomy intra-abdominal abscesses between laparoscopic and open appendectomies.
• To evaluate the safety and efficacy of laparoscopic appendectomy in cases of perforated appendicitis.

Main Methods:

• Retrospective review of 2497 appendectomies (March 1993-September 1995) at a single medical center.
• Exclusion of incidental appendectomies and pediatric cases (<18 years).
• Classification based on intraoperative diagnosis: acute, gangrenous, or perforated appendicitis.

Main Results:

• No significant difference in abscess rates for acute or gangrenous appendicitis between laparoscopic and open approaches.
• For perforated appendicitis, laparoscopic appendectomy had a significantly higher abscess rate (9.0%) than open appendectomy (2.6%, P=0.015).
• No significant difference in postoperative hospital stay between laparoscopic and open appendectomy for perforated appendicitis.

Conclusions:

• Laparoscopic appendectomy for perforated appendicitis is associated with a higher risk of intra-abdominal abscess formation.
• The increased complication rate with laparoscopic appendectomy for perforated appendicitis is not offset by a shorter hospital stay.
• Laparoscopic appendectomy is not recommended for patients diagnosed with perforated appendicitis based on these findings.