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ISSN: 1895-4588
Videosurgery and Other Miniinvasive Techniques
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1/2019
vol. 14
 
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abstract:
Original paper

Risk factors for intraabdominal abscess formation after laparoscopic appendectomy – results from the Pol-LA (Polish Laparoscopic Appendectomy) multicenter large cohort study

Anna Lasek
,
Michał Pędziwiatr
,
Michał Wysocki
,
Judene Mavrikis
,
Piotr Myśliwiec
,
Tomasz Stefura
,
Maciej Bobowicz
,
Piotr Major
,
Mateusz Rubinkiewicz
,
Pol-LA (Polish Laparoscopic Appendectomy) Collaborative Study Group

Videosurgery Miniinv 2019; 14 (1): 70–78
DOI: https://doi.org/10.5114/wiitm.2018.77272
Online publish date: 2018/07/24
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Introduction
According to meta-analyses laparoscopic appendectomy is associated with many benefits. However, in comparison to open surgery an increased rate of intraabdominal abscesses (IAA) has been reported. Identification of predictive factors for this complication may help to identify patients with higher risk of IAA.

Aim
To identify potential risk factors for intraabdominal abscess after laparoscopic appendectomy (LA).

Material and methods
Eighteen surgical units in Poland and Germany submitted data of patients undergoing LA to the online web-based database created by the Polish Videosurgery Society of the Association of Polish Surgeons. It comprised 31 elements related to the pre-, intra- and postoperative period. Surgical outcomes were compared among the groups according to occurrence of IAA. Univariate and multivariate logistic regression models were used to identify potential risk factors for IAA.

Results
4618 patients were included in the analysis. IAA were found in 51 (1.10%) cases. Although several risk factors were found in univariate analysis, in the multivariate model, only the presence of complicated appendicitis was statistically significant (OR = 2.98, 95% CI: 1.11–8.04). Moreover, IAA has a significant influence on postoperative reintervention rate (OR = 126.95, 95% CI: 67.98–237.06), prolonged length of stay > 8 days (OR = 41.32, 95% CI: 22.86–74.72) and readmission rate (OR = 33.89, 95% CI: 18.60–34.73).

Conclusions
Intraabdominal abscesses occurs relatively rarely after LA. It is strongly associated with complicated appendicitis. Occurrence of this complication has a great influence on the postoperative period and due to the nature of its treatment is associated with the need for reintervention, prolonged length of stay and by extension possible readmission.

keywords:

laparoscopic appendectomy, acute appendicitis, complications, intraabdominal abscess, complicated appendicitis
  
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