Incidence of postoperative intraabdominal abscesses in open versus laparoscopic appendectomies

Abstract

No significant difference in the occurrence of IAA after LA versus OA was found. The patients with complicated appendicitis experienced a greater number of IAA than the patients with uncomplicated appendicitis.

Pelvic sepsis following laparoscopic appendicectomy versus open appendicectomy: a retrospective study of 648 cases

“…The current literature demonstrates conflicting evidence with some studies suggesting that LA is associated with a higher risk of developing pelvic sepsis, 13,14,18,22 and other studies concluding that this is not significant. 8,[10][11][12]16,19,21 Our study reports 19 patients with pelvic sepsis (laparoscopic n = 2, open n = 17) demonstrating no statistically significant difference in pelvic sepsis between the two operative groups (p = 0.1184). Although there was no significant difference, LA was associated with a decreased risk of pelvic sepsis.…”

“…The majority of collections were found in the RIF, pelvis and right paracolic gutter, this does not support the mechanism of possible diffusion that has been mentioned in the literature to date. 10,13,18 Further studies have evaluated the rates of pelvic sepsis in complicated appendicitis and have concluded that there is a statistically significant increase in pelvic sepsis rates in patients with complicated appendicitis. 10,13,18,22 Frazee and Bohannon 14 published a retrospective analysis in which 19 patients with perforated appendicitis and 15 patients with gangrenous appendicitis underwent LA.…”

“…12 Another study reports that LA should decrease the incidence of pelvic sepsis as the procedure allows better visualisation of the abdominal cavity and a thorough washout of all abdominal quadrants. 10 However this is contradicted by a study reporting that extensive irrigation carried out during LA and the handling of a perforated appendix within the abdomen leads to contamination of the abdominal cavity. 13 The majority of studies demonstrating a statistically significant difference between LA and OA were performed in the late 1990s through to the early 2000s including a randomised trial by Pedersen et al 8,16,19,21 It is possible that in the last decade laparoscopic appendicectomy has developed enough to demonstrate a decrease in the rates of pelvic sepsis.…”

“…9 Since that time the advantages of the laparoscopic technique have been well demonstrated and Laparoscopic Appendicectomy (LA) has become the preferred procedure over OA in hospitals worldwide. [10][11][12][13][14][15] Advantages of LA include reduced postoperative pain and cosmesis. 8,12,[14][15][16][17][18][19][20][21] Despite the popularity of LA, it is still a controversial subject and some studies demonstrate a preference towards OA.…”

“…8,[10][11][12]16,19,21 A study by Sleem et al suggests that LA is safe to use in cases of perforated appendicitis with no evidence of increased rate of postoperative pelvic collection when compared with OA. 12 Another study reports that LA should decrease the incidence of pelvic sepsis as the procedure allows better visualisation of the abdominal cavity and a thorough washout of all abdominal quadrants.…”