BACKGROUND: Possible risk factors for postoperative intra-abdominal abscess (IAA) formation after laparoscopic appendectomy (LA) remain controversial. A perforated appendicitis, diabetes mellitus, peritoneal irrigation, obesity and age are considered to be possible risk factors for postoperative IAA, but the existing evidence is insufficient. This study aimed to identify the risk factors for IAA formation in patients receiving LA. METHODS: Between January 2010 and December 2013, 1,817 patients who underwent 3-port LA were enrolled in this study. Patients were classified into 2 groups according to the development of postoperative IAA, and the differences between the groups were analyzed. RESULTS: The incidence of IAA after LA was 1.5%, and the only identified risk factor for IAA was peritoneal irrigation. On logistic regression analysis of those patients who received peritoneal irrigation, suppurative appendicitis and non-placement of the peritoneal drain were found to be significant risk factors for the development of IAA. CONCLUSIONS: Peritoneal irrigation in a case of abdomen contamination was shown to be a risk factor for the development of postoperative IAA after LA. When peritoneal irrigation is performed, surgeons should consider using peritoneal drainage and postoperative antibiotics (including anti-anaerobic antibiotics) to prevent postoperative IAA formation.
BACKGROUND: Possible risk factors for postoperative intra-abdominal abscess (IAA) formation after laparoscopic appendectomy (LA) remain controversial. A perforated appendicitis, diabetes mellitus, peritoneal irrigation, obesity and age are considered to be possible risk factors for postoperative IAA, but the existing evidence is insufficient. This study aimed to identify the risk factors for IAA formation in patients receiving LA. METHODS: Between January 2010 and December 2013, 1,817 patients who underwent 3-port LA were enrolled in this study. Patients were classified into 2 groups according to the development of postoperative IAA, and the differences between the groups were analyzed. RESULTS: The incidence of IAA after LA was 1.5%, and the only identified risk factor for IAA was peritoneal irrigation. On logistic regression analysis of those patients who received peritoneal irrigation, suppurative appendicitis and non-placement of the peritoneal drain were found to be significant risk factors for the development of IAA. CONCLUSIONS: Peritoneal irrigation in a case of abdomen contamination was shown to be a risk factor for the development of postoperative IAA after LA. When peritoneal irrigation is performed, surgeons should consider using peritoneal drainage and postoperative antibiotics (including anti-anaerobic antibiotics) to prevent postoperative IAA formation.
Authors: Anna Lasek; Michał Pędziwiatr; Michał Wysocki; Judene Mavrikis; Piotr Myśliwiec; Tomasz Stefura; Maciej Bobowicz; Piotr Major; Mateusz Rubinkiewicz Journal: Wideochir Inne Tech Maloinwazyjne Date: 2018-07-24 Impact factor: 1.195
Authors: Anne Loes van den Boom; Elisabeth M L de Wijkerslooth; Joost van Rosmalen; Frédérique H Beverdam; Evert-Jan G Boerma; Marja A Boermeester; Joanna W A M Bosmans; Thijs A Burghgraef; Esther C J Consten; Imro Dawson; Jan Willem T Dekker; Marloes Emous; Anna A W van Geloven; Peter M N Y H Go; Luc A Heijnen; Sander A Huisman; Dayanara Jean Pierre; Joske de Jonge; Jurian H Kloeze; Marc A Koopmanschap; Hester R Langeveld; Misha D P Luyer; Damian C Melles; Johan W Mouton; Augustinus P T van der Ploeg; Floris B Poelmann; Jeroen E H Ponten; Charles C van Rossem; Wilhelmina H Schreurs; Joël Shapiro; Pascal Steenvoorde; Boudewijn R Toorenvliet; Joost Verhelst; Hendt P Versteegh; Rene M H Wijnen; Bas P L Wijnhoven Journal: Trials Date: 2018-05-02 Impact factor: 2.279