Surgical site infection after laparoscopic and open appendectomy: a multicenter large consecutive cohort study

Xiao, Yan; Su, Gang; Zhang, Jin; Cao, Jianguo; Liu, Lijun; Chen, Ting‐Hao; Li, Zhizhou; Wang, Hong; Zhang, Han; Zhou, Lin; Lü, Junhua; Yang, Tian

doi:10.1007/s00464-014-3809-y

Cited by 65 publications

(39 citation statements)

References 54 publications

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“…B, The reusable retrieval bag with the appendix inside was extracted through port without contact with wound or contamination of abdominal cavity. (28,29). In patients with acute appendicitis, the incidence of SSIs has been reported to be 2.8 -12.8 % with laparoscopic appendectomy and 4.6% -9.7 % with open appendectomy (7,30).…”

Section: Discussionmentioning

confidence: 99%

Surgical Wound Infections After Laparoscopic Appendectomy With or Without Using Reusable Retrieval Bag: A Retrospective Study

Lasheen

Elaziz

Elaal

et al. 2016

J Minim Invasive Surg Sci

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Background: Despite the reported advantages of laparoscopic appendectomy (LA), an ongoing debate exists about a possible increase in postoperative infectious complication rates. The analyses of risk factors associated with surgical site infections (SSIs) after LA, have been limited. Patients and Methods: One hundred twenty laparoscopic appendectomies performed over one year, were included in this retrospective study. The patients were divided into 2 group; group A was the one in which LA was done with using reusable retrieval bag and group B without using that. Demographic details, operative time, hospital stay and infective postoperative complications were recorded. Results: This patient groups were selected to be similar in both groups A and B in form of appendicitis types. Each group included 27 (45%) acute catarrhal appendicitis, 20 (33.3%) suppurative appendicitis and 13 (21.7%) perforated appendicitis, P = 1.0. The median patients ages were 21 years (range, 16 to 49) in group A and 25 years (range, 18 to 56) in group B, P = 0.053. Group A included 60 patients (35 males and 25 females) and group B 60 patients (32 males and 28 females), P = 0.071. Mean operative time in group A was 55.7 minutes and in group B was 57 minutes, P = 0.0231. Superficial wound infections were recorded in one patient (1.7%) in group A and in 8 patients (13.3%) in group B, P = 0.007. Intra-abdominal abscess formation was a complicated outcome in 2 patients (3.3%) of group B, P = 0.005. Mean hospital stay was 1.6 days in group A and 2.7 days in group B, P = 0.05. Conclusions: Surgical wound infections are less common by using reusable retrieval bag during laparoscopic appendectomy procedure. Also, using reusable retrieval bag has less cost.

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Section: Discussionmentioning

confidence: 99%

Surgical Wound Infections After Laparoscopic Appendectomy With or Without Using Reusable Retrieval Bag: A Retrospective Study

Lasheen

Elaziz

Elaal

et al. 2016

J Minim Invasive Surg Sci

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“…Ever since, inconsistent results have been reported regarding the potential higher incidence of IAA after LA [53–61]. Benefits of LA over OA reported in meta-analyses are: reduced incidence of SSI, post-operative and long-term bowel obstruction with better outcome in terms of shorter hospital stay, its diagnostic value, less pain, earlier return to work, earlier start of oral intake, improved scar and body satisfaction and fewer incisional hernias [54, 55, 58, 61–66]. Disadvantages besides the possible higher incidence of IAA are longer operating time and possibly increased costs [58, 63].…”

Section: Pre-operative Carementioning

confidence: 99%

Diagnosis and management of acute appendicitis. EAES consensus development conference 2015

et al. 2016

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Unequivocal international guidelines regarding the diagnosis and management of patients with acute appendicitis are lacking. The aim of the consensus meeting 2015 of the EAES was to generate a European guideline based on best available evidence and expert opinions of a panel of EAES members. After a systematic review of the literature by an international group of surgical research fellows, an expert panel with extensive clinical experience in the management of appendicitis discussed statements and recommendations. Statements and recommendations with more than 70 % agreement by the experts were selected for a web survey and the consensus meeting of the EAES in Bucharest in June 2015. EAES members and attendees at the EAES meeting in Bucharest could vote on these statements and recommendations. In the case of more than 70 % agreement, the statement or recommendation was defined as supported by the scientific community. Results from both the web survey and the consensus meeting in Bucharest are presented as percentages. In total, 46 statements and recommendations were selected for the web survey and consensus meeting. More than 232 members and attendees voted on them. In 41 of 46 statements and recommendations, more than 70 % agreement was reached. All 46 statements and recommendations are presented in this paper. They comprise topics regarding the diagnostic work-up, treatment indications, procedural aspects and post-operative care. The consensus meeting produced 46 statements and recommendations on the diagnostic work-up and management of appendicitis. The majority of the EAES members supported these statements. These consensus proceedings provide additional guidance to surgeons and surgical residents providing care to patients with appendicitis. Electronic supplementary materialThe online version of this article (doi:10.1007/s00464-016-5245-7) contains supplementary material, which is available to authorized users.

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“…The laparoscopic approach was most commonly found to decrease the number of superficial surgical site infections (SSIs), and therefore considered to be a preferable approach with respect to postoperative pain, length of hospital stay, and time to return to work. The open approach has been found to have a shorter duration of surgery and lower risk of intra-abdominal abscess formation [3][4][5][6][7]. Reported perforation rates vary in the range 12-29% and several prior studies have not been able to show that a more proactive management decreases the perforation rate [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Trends in the Management of Acute Appendicitis in a Single-Center Quality Register Cohort of 5,614 Patients

Dahlberg

Boström²

2017

Dig Surg

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Acute appendicitis is one of the most common reasons for emergency surgery. At Stockholm South General Hospital, information on all patients - 15 years or older - undergoing surgery for acute appendicitis is included in a quality register. Data on surgical method, preoperative imaging, hospital stay, intraoperative findings, and 30-day complications were recorded for each patient. From January 2004 to December 2014, 5,614 consecutive patients were registered. The percentage of patients examined with preoperative imaging increased from 30% in 2004 to 93% in 2014. The use of laparoscopic appendectomy increased from 6 to 79%. Negative appendectomies decreased from 7.5-10 to 1.7%. The mean perforation rate was 28.6%. Some form of postoperative complication occurred in 6.6% of those on whom laparoscopy was performed and 10.5% of those who underwent an open surgery, with a significant difference (p < 0.001) in the rate of surgical site infections (surgical site infections, higher in open cases) but with no difference in the number of deep postoperative abscesses. The overall hospital stay decreased from 2004 to 2014 for perforated and non-perforated appendicitis. The overall 30-day mortality rate was 0.12%. Changes in preoperative imaging and treatment strategy for appendicitis during this period resulted in a lower rate of negative appendectomies with acceptable complication rates and shortened hospital stay.

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Surgical site infection after laparoscopic and open appendectomy: a multicenter large consecutive cohort study

Abstract: With the increasing application trends of laparoscopic procedure, the incidence of SSI after appendectomy declined accordingly. Compared with OA, LA was independently associated with a significantly lower incidence of incisional SSI, but a similar incidence of organ/space SSI.

Cited by 65 publications

References 54 publications

Surgical Wound Infections After Laparoscopic Appendectomy With or Without Using Reusable Retrieval Bag: A Retrospective Study

Surgical Wound Infections After Laparoscopic Appendectomy With or Without Using Reusable Retrieval Bag: A Retrospective Study

Diagnosis and management of acute appendicitis. EAES consensus development conference 2015

Trends in the Management of Acute Appendicitis in a Single-Center Quality Register Cohort of 5,614 Patients

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