title: [Intraabdominal septic complications in laparoscopic appendectomy: description of a possible new intraabdominal septic complication specific to laparoscopic appendectomy].
abstract: BACKGROUND
  Controversies about laparoscopic appendectomy (LA) focus mainly on the high intraabdominal infection rate. In 2005, Serour et al described a distinct complication specific to LA, termed "postlaparoscopic appendectomy complication" (PLAC). This complication is an intraabdominal infection, without abscess formation, which develops after laparoscopic appendectomy for non-complicated appendicitis (simple, phlegmonous, or normal appendix) and is observed in patients discharged after an uneventful postoperative period. We reviewed our case series to establish our intraabdominal infection rate in appendectomy and to identify cases similar to this newly described complication.
  
  
  METHODS
  We retrospectively reviewed 651 clinical records of appendectomy performed by the laparoscopic (LA) or open approach (OA) over an 11-year period in our hospital. The criteria for a diagnosis of PLAC were as follows: a) clinical criteria: uneventful appendectomy (OA or LA), asymptomatic status on hospital discharge, and onset of right lower quadrant pain, fever, and elevated white blood cell count after discharge; b) pathologic criteria: non-complicated appendicitis (gangrenous or perforated appendicitis were excluded), and c) ultrasound scan showing characteristic features.
  
  
  RESULTS
  A total of 432 LA and 219 OA were reviewed. The conversion rate was 11.1%. The main complications (intention-to-treat analysis) were wound infection (6.3% in LA versus 7.8% in OA) and intraabdominal infection (4.2% in LA versus 2.3% in OA). Four out of 18 cases of intraabdominal infection after LA fulfilled PLAC criteria, representing 1% of all LA and 22% of intraabdominal infections after LA.
  
  
  CONCLUSIONS
  LA seems to be associated with an increased risk of intraabdominal infection. Our results suggest that a distinct form of intraabdominal infection specific to laparoscopic appendectomy may exist.
authors.affiliation: Hospital Comarcal de Laredo, Servicio Cántabro de Salud, Laredo, Cantabria, Spain. gsolerdorda@telefonica.net
authors.forename: Guillermo
authors.initials: G
authors.lastname: Soler-Dorda
authors.forename: María José
authors.initials: MJ
authors.lastname: Fernández-Díaz
authors.forename: Ignacio
authors.initials: I
authors.lastname: Martín-Parra
authors.forename: José Luis
authors.initials: JL
authors.lastname: Alonso-Gayón
authors.forename: Jose Luis
authors.initials: JL
authors.lastname: Conty-Serrano
authors.forename: María Antonia
authors.initials: MA
authors.lastname: de Andrés-Fuertes
authors.forename: José María
authors.initials: JM
authors.lastname: Bárcena-Barros
mesh_terms: D000005:Abdomen; D000293:Adolescent; D000328:Adult; D000368:Aged; D001062:Appendectomy / Q000009:adverse effects* / Q000379:methods*; D005260:Female; D006801:Humans; D015994:Incidence; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018805:Sepsis / Q000209:etiology*