The utility of intraperitoneal drain placement after laparoscopic appendectomy for perforated appendicitis in postoperative intraperitoneal abscess prevention.

Autor: Alabbad J; Mubarak Al-Kabeer Hospital, Jabriya, Kuwait. jasim.alabbad@ku.edu.kw.; Department of Surgery, College of Medicine, Kuwait University, P.O. Box 24923, 3110, Safat, Kuwait. jasim.alabbad@ku.edu.kw., Alhamly H; Mubarak Al-Kabeer Hospital, Jabriya, Kuwait., Alrubaiaan A; Mubarak Al-Kabeer Hospital, Jabriya, Kuwait., Kabli A; Mubarak Al-Kabeer Hospital, Jabriya, Kuwait., Abdulraheem F; Mubarak Al-Kabeer Hospital, Jabriya, Kuwait.
Jazyk: angličtina
Zdroj: Surgical endoscopy [Surg Endosc] 2024 Jul; Vol. 38 (7), pp. 3571-3577. Date of Electronic Publication: 2024 May 15.
DOI: 10.1007/s00464-024-10869-w
Abstrakt: Background: Perforated appendicitis is associated with postoperative development of intraperitoneal abscess. Intraperitoneal drain placement during appendectomy is thought to reduce the risk of developing postoperative intraperitoneal abscess. The aim of this study was to determine whether intraperitoneal drainage could reduce the incidence of intraperitoneal abscess formation after laparoscopic appendectomy for perforated appendicitis.
Methods: This is a retrospective study of all patients (aged 7 and above) who were diagnosed with perforated appendicitis and subsequently underwent laparoscopic appendectomy between January 2018 and December 2022 at two government hospitals in the state of Kuwait. Demographic, clinical, and perioperative characteristics were compared between patients who underwent intraoperative intraperitoneal drain placement and those who did not. The primary outcome was the development of postoperative intraperitoneal abscess. Secondary outcomes included overall postoperative complications, superficial surgical site infection (SSI), length of stay (LOS), readmission and postoperative percutaneous drainage.
Results: A total of 511 patients met the inclusion criteria between 2018 and 2022. Of these, 307 (60.1%) underwent intraoperative intraperitoneal drain placement. Patients with and without drains were similar regarding age, sex, and Charlson Comorbidity Index (CCI) (Table 1). The overall rate of postoperative intraperitoneal abscess was 6.1%. Postoperatively, there was no difference in postoperative intraperitoneal abscess formation between patients who underwent intraperitoneal drain placement and those who did not (6.5% vs. 5.4%, p = 0.707). Patients with intraperitoneal drains had a longer LOS (4 [4, 6] vs. 3 [2, 5] days, p < 0.001). There was no difference in the overall complication (18.6% vs. 12.3%, p = 0.065), superficial SSI (2.9% vs. 2.5%, p = 0.791) or readmission rate (4.9% vs. 4.4%, p = 0.835).
Conclusions: Following laparoscopic appendectomy for perforated appendicitis, intraperitoneal drain placement appears to confer no additional benefit and may prolong hospital stay.
(© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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