A simple scoring system to reduce intraabdominal septic complications after laparoscopic appendectomy.
BACKGROUND
The development of intraabdominal abscess (IAA) following laparoscopic appendectomy (LA) is associated with significant morbidity. The aim of the present study was to validate an IAA risk score constructed from a previous review of 156 consecutive LA.


METHODS
The score was tested in 250 subsequent consecutive LA and in patients with a positive risk score. Broad-spectrum antibiotics were administered in order to avoid IAA.


RESULTS
Factors related to IAA included clinically complicated appendicitis, leucocytosis >15,000/microl, a difference of >1 degrees C between axillary and rectal temperature, intraoperative findings such as (gangrenes and perforation), and intraoperative perforation of the appendix. In this series, broad-spectrum antibiotic therapy in patients with a positive IAA risk score reduced the incidence of IAA from 7.05% to 1.60%.


CONCLUSIONS
This policy of identifying high-risk patient via the scoring system and instituting subsequent antibiotic therapy in patients at risk reduces the incidence of IAA following LA.
Serralta
A
A
Servicio de Cirugía General y del Aparato Digestivo II, Hospital Universitario "La Fe", Avda Campanar 21, 46009 Valencia, Spain.
Planells
M
M
Bueno
J
J
Rodero
D
D
D018784:Abdominal Abscess / Q000517:prevention & control*; D000208:Acute Disease; D000328:Adult; D019072:Antibiotic Prophylaxis; D001062:Appendectomy / Q000706:statistics & numerical data; D001064:Appendicitis / Q000150:complications / Q000601:surgery; D001499:Bayes Theorem; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000706:statistics & numerical data; D008297:Male; D011183:Postoperative Complications / Q000517:prevention & control*; D011379:Prognosis; D011446:Prospective Studies; D015203:Reproducibility of Results; D012307:Risk Factors; D018805:Sepsis / Q000517:prevention & control*