Fear for the intraabdominal abscess after laparoscopic appendectomy: not realistic.
BACKGROUND
The risk for intraabdominal abscess (IAA) after laparoscopic appendectomy (LA) is still a matter of debate. The aim of the present study was to evaluate postoperative complications after open (OA) and laparoscopic appendectomy, in particular in perforated appendicitis (PA).


METHODS
In the period 1999-2002, 331 appendectomies were performed for histological proven appendicitis, 144 by the open and 187 by the laparoscopic technique. Parameters were conversion rate, perforation, wound infection, and IAA.


RESULTS
Conversion to OA was done in 20 cases (10.7%). Perforated appendicitis led more frequently to conversion than simple appendicitis (23.5 vs 7.8%; p = 0.007). Perforated appendicitis was equally seen in the open and laparoscopic technique (15 vs 18%). Wound infections after OA, converted and LA for acute appendicitis were 3 of 144 (2.1%), 1 of 20 (5.0%) and 1 of 167 (0.6%), respectively (NS). IAA formation did not differ among the three procedures (3.5 vs 0 vs 3.6%). In PA the rate of IAA formation was increased. However, the risk was not influenced by the technique: Two patients after the OA, none after a converted procedure, and two patients after LA formed an abscess (9.5 vs 0 vs 7.7% [NS]).


CONCLUSIONS
LA does not lead to more intraabdominal abscesses than the open technique; even for perforated appendicitis the laparoscopic technique can be used safely.
Kouwenhoven
E A
EA
Department of Surgery, Máxima Medical Centre, P.O. Box 90052, 5600 PD Eindhoven, The Netherlands. eakouwenhoven@zonnet.nl
Repelaer van Driel
O J
OJ
van Erp
W F M
WF
D018784:Abdominal Abscess / Q000453:epidemiology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D001062:Appendectomy / Q000009:adverse effects / Q000379:methods; D001064:Appendicitis / Q000601:surgery; D002648:Child; D005260:Female; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000453:epidemiology