- Poster presentation
- Open Access
Risk factors for post-operative intra-abdominal abscess after laparoscopic appendectomy: a case-control study
Intensive Care Medicine Experimental volume 3, Article number: A121 (2015)
The risk factors for post-operative intra-abdominal abscess (IAA) formation after laparoscopic appendectomy (LA) remain debatable. Some advocate that a perforated appendicitis or Diabetes Mellitus may increase the incidence of post-operative IAA; however, the existing evidence is insufficient.
This study aimed to identify risk factors and non-risk factors for IAA formation in patients receiving LA.
From January 2010 to December 2013, all patients who underwent three-port LA and who were histologically diagnosed with appendicitis were included. We classified these patients into two groups according to their development of post-operative IAA and then analyzed the differences between the groups.
Overall, 1790 patients showed no post-operative complications and were assigned to the non-complication group, whereas 27 patients suffered from IAA postoperatively and were assigned to the IAA group. The incidence of IAA after LA was 1.4% and the only identified risk factor for IAA was dirty fluid collection in the peritoneal cavity observed during the operation. (P < 0.001) On logistic regression analysis of those patients who demonstrated dirty fluid collection, the non-placement of a peritoneal drain had statistical significance for the development of IAA. (P < 0.001)
In the present study, the presence of dirty fluid collection in the peritoneal cavity rather than the type of appendicitis was demonstrated as a risk factor for the development of post-operative IAA after LA. When such fluid collection is observed, surgeons should consider deploying peritoneal drainage and post-operative antibiotics treatment including anti-anaerobic treatment.
Reid RI, Dobbs BR, Frizelle FA: Risk factors for post-appendicectomy intra-abdominal abscess. Aust N Z J Surg. 1999, 69: 373-4. 10.1046/j.1440-1622.1999.01576.x.
Ming PC, Yan TY, Tat LH: Risk factors of postoperative infections in adults with complicated appendicitis. Surg Laparosc Endosc Percutan Tech. 2009, 19: 244-8. 10.1097/SLE.0b013e3181a4cda2.
Solomkin JS, Mazuski JE, Bradley JS, Rodvold KA, Goldstein EJ, Baron EJ, O´Neill PJ, Chow AW, Dellinger EP, Eachempati SR, Gorbach S, Hilfiker M, May AK, Nathens AB, Sawyer RG, Bartletts JG: Diagnosis and management of complicated intra-abdominal infection in adults and children: guidelines by the Surgical Infection Society and the Infectious Diseases Society of America. Surg Infect. 2010, 11: 79-109. 10.1089/sur.2009.9930.
Petrowsky H, Demartines N, Rousson V, Clavien PA: Evidence-based value of prophylactic drainage in gastrointestinal surgery: a systematic review and meta-analyses. Ann Surg. 2004, 240: 1074-84. 10.1097/01.sla.0000146149.17411.c5.
Allemann P, Probst H, Demartines N, Schäfer M: Prevention of infectious complications after laparoscopic appendectomy for complicated acute appendicitis--the role of routine abdominal drainage. Langenbecks Arch Surg. 2011, 396: 63-8. 10.1007/s00423-010-0709-z.
About this article
Cite this article
Cho, J., Lee, J. & Sung, K. Risk factors for post-operative intra-abdominal abscess after laparoscopic appendectomy: a case-control study. ICMx 3, A121 (2015) doi:10.1186/2197-425X-3-S1-A121
- Diabetes Mellitus
- Logistic Regression
- Logistic Regression Analysis
- Antibiotic Treatment