2012, Number 1
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Rev Latinoam Cir 2012; 2 (1)
Postoperative intraabdominal abscess. Comparison between laparoscopic vs conventional appendectomy
Peruyero MJA, González CJR, Hernández PJA
Language: Spanish
References: 16
Page: 21-25
PDF size: 83.20 Kb.
ABSTRACT
Background: There is discussion on the potential impact of intra-abdominal abscedation in patients undergoing laparoscopic versus conventional (open) appendectomy.
Materials and methods: Records from a private hospital in northeastern Mexico were studied. The decision of surgical technique was preference of each individual surgeon. Registered variables were clinical, paraclinical and postoperative (abdominal abscess).
Results: 322 laparoscopic and 40 open surgery patients were included. There was gender disproportion (greater fraction of women in open surgery) and comorbidity (more diabetes mellitus and systemic hypertension in open surgery). There were no significant differences in age, nor hours of pre-surgical evolution. Leukocyte count, the use of ultrasound and tomography tended to be higher in open surgery patients. This group had more cases of perforated appendicitis (25
vs 3%); more drains were placed (38
vs 12%) and hospital stay was longer (3.5
vs 2.0 days). Open surgery group also had the highest proportion of postoperative intra-abdominal abscess (13
vs 1%).
Conclusion: This is a limited non-randomized observation; the preference of the individual surgeon for either type of intervention is a confounding variable impossible to control. Open surgery patients had clearly worse pre-surgical situation, operative findings and postoperative evolution. Surgeons tended to opt for open surgery when the case was anticipated to be complicated. Literature agrees that greater degree of severity of appendicitis have higher probability to form intra-abdominal abscesses in the postoperative period and this seems to be the important factor, not the surgical technique chosen.
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