Risk factors for intra-abdominal abscess following laparoscopic appendectomy for acute appendicitis: a retrospective cohort study on 2076 patients.

Abstract

BACKGROUND:

Intra-abdominal abscesses (IAA) may develop after laparoscopic appendectomies (LA) for acute appendicitis. The identification of risk factors for postoperative IAA could lead to a decrease in the readmission rate and surgery redoes after LA for acute appendicitis.

MATERIALS AND METHODS:

The present study retrospectively analyzed patients undergone LA for acute appendicitis during the period 2001-2017. Clinical, intraoperative, and postoperative outcomes were described. Comparison between groups was made via univariate and multivariate analyses.

RESULTS:

The charts of 2076 patients undergone LA were reviewed. Thirty-seven patients (1.8%) developed a postoperative IAA. Male gender (p < 0.05), ASA score ≥ 2 (p < 0.05), a gangrenous or perforated appendicitis (p < 0.0001), abscess or pelvic peritonitis (p < 0.0001), clipping the mesoappendix (p < 0.0001), appendix division by mechanical stapler (p < 0.05), prolonged antibiotic therapy (p < 0.05), and piperacillin/tazocin regimen (p < 0.0001) were significantly more frequent in the group of patients with IAA. In terms of multivariate analysis, only pelvic peritonitis (p = 0.010), perforated appendicitis (p = 0.0002), and clipping the mesoappendix (p = 0.0002) were independent predictive factors for postoperative IAA.

CONCLUSION:

Patients with peritonitis or a perforated appendicitis, and those who had their mesoappendix clipped showed a higher likelihood of developing an IAA. At risk patients should be provided with careful follow-up for the early detection and management of this complication.

• Authors: Dario Tartaglia, Lorenzo Maria Fatucchi, Alessio Mazzoni, Mario Miccoli, Lorenzo Piccini, Marsia Pucciarelli, Salomone Di Saverio, Federico Coccolini, Massimo Chiarugi
• Journal: Updates in surgery (Updates Surg) Vol. 72 Issue 4 Pg. 1175-1180 (Dec 2020) ISSN: 2038-3312 [Electronic] Italy
• PMID: 32338352 (Publication Type: Journal Article)

Topics

• Abdominal Abscess (epidemiology, etiology)
• Acute Disease
• Adolescent
• Adult
• Appendectomy (methods)
• Appendicitis (surgery)
• Child
• Cohort Studies
• Female
• Humans
• Laparoscopy (methods)
• Male
• Peritonitis
• Postoperative Complications (epidemiology, etiology)
• Retrospective Studies
• Risk Factors
• Surgical Instruments
• Treatment Outcome
• Young Adult