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

Abstract

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.

Does the Stump Knotting Technique and Specimen Retrieval Method Effects Morbidity and Outcomes in Laparoscopic Appendectomy?

“…[18,19] The use of specimen retrieval bag reduces the ratio of SSI after LA. [20] We obtained similar results with the literature; all of the five patients who developed SSI, their appendix were removed from the abdomen without using specimen retrieval bag. On the other hand, no SSI was observed in any of the patients in the group that used specimen retrieval bag.…”

“…The defined risk factor for surgical site infection (SSI) after LA is the contamination of trocar entry area by inflamed appendicitis. [18][19][20] This study aims to compare the single and double extracorporeal knot technique for stump closure and specimen retrieval methods used in LA.…”

Comparative Study of Surgical Site Infection between Laparoscopic Appendectomy and Open Appendectomy

“…The difference was not statistically significant (p>0.05) between two groups. Similar results was found 18 observed that the severity of appendicitis was similar in both groups (27 catarrhal appendicitis 45%, 20 suppurative appendicitis 33.3% and 13 perforated appendicitis 21.7%). In the study of Suh et al 4 showed hyperemic was found 16.7% in OA group and 17.0% in LA group.…”

“…Similar observation was found in different studies Kargar et al 15 study showed the average skin to skin operation time was 34.4± 8.42 min in LA hand and 41.7± 8.84 in OA hand (P=0001). In study of Lasheen et al 18 showed the mean operative time in group A was 55.7 minutes (range, 27 to 90) and in group B 57 minutes (range, 25 to 95), P = 0.0231. In study of Biondi et al 13 showed the mean ± standard deviation (SD) operative time of 54.9 ± 14.7 min for the LA group was longer than the mean operative time of 31.36 ± 11.43 min for open appendectomy (P <0.0001).…”

“…Two patient in the LA group required conversion to open operation. In Lasheen et al 18 study observed that port wound infection was recorded in one patient of group A (1.7%) and 8 patients (13.3%) in group B, P = 0.007, 2017 Volume 29 Number 01 10 ORIGINAL ARTICLE which was managed by drainage and daily dressing as outpatient. In Suh et al 4 study also observed readmission within 30 days of surgery was observed in 2 cases (0.6%) in the LA group and 9 cases (2.1%) in the OA group, but the difference was not statistically significant.…”