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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.
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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). https://doi.org/10.1186/2197-425X-3-S1-A121
- Diabetes Mellitus
- Logistic Regression
- Logistic Regression Analysis
- Antibiotic Treatment