Intraabdominal abscess rate after laparoscopic appendectomy
| Autor: | Kranthi K Achanta, Rahila Essani, Guillermo Campos, Eli Mavor, Steven W. Grant, Namir Katkhouda, Rodney J. Mason, Peter Paik, Melanie H. Friedlander, George C. Velmahos |
|---|---|
| Rok vydání: | 2001 |
| Předmět: |
Laparoscopic surgery
Adult Male medicine.medical_specialty Abdominal Abscess Adolescent medicine.medical_treatment Gangrene Postoperative Complications medicine Appendectomy Humans Abscess Laparoscopy Aged medicine.diagnostic_test business.industry General surgery General Medicine Middle Aged medicine.disease Appendicitis Surgery Endoscopy medicine.anatomical_structure Treatment Outcome Intestinal Perforation Abdomen Female Clinical Competence Complication business |
| Zdroj: | American journal of surgery. 180(6) |
| ISSN: | 0002-9610 |
| Popis: | Background: Studies suggest increased intraabdominal abscess (IA) rates following laparoscopic appendectomy (LA), especially for perforated appendicitis. Consequently, an open approach has been advocated. The aim of our study is to compare IA rates following LA performed by a laparoscopic surgery and a general surgical service within the same institution. Methods: Data of LA patients treated at Los Angeles County-University of Southern California (LAC-USC) Medical Center between March 1992 and June 1997 were reviewed. The main outcome measure was postoperative IA. Results: In all, 645 LA were reviewed. A total of 413 LA (285 acute, 61 gangrenous, 67 perforated appendicitis) were performed by three general surgical services (10 attendings). Ten abscesses occurred postoperatively (2.4%), 6 with perforated appendicitis. After the laparoscopic service was introduced, 232 standardized LA (126 acute, 46 gangrenous, 60 perforated) were performed by two attendings. One IA occurred (gangrenous appendicitis). The IA rate for perforated appendicitis was significantly lower on the laparoscopic service ( P = 0.025). There was no difference in IA rates for acute and gangrenous appendicitis. There was no mortality in either group. Conclusion: IA rate following LA for perforated appendicitis was significantly reduced on the laparoscopic service. Mastery of the learning curve and addition of specific surgical techniques explained this improved result. Therefore, laparoscopic appendectomy for complicated appendicitis may not be contraindicated, even for perforated appendicitis. |
| Databáze: | OpenAIRE |
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