title: What patients and surgeons should know about the consequences of appendectomy for acute appendicitis after long-term follow-up: factors influencing the incidence of chronic abdominal complaints.
abstract: BACKGROUND
  Abscess formation and perforation are complications of acute appendicitis that lead to localized or generalized peritonitis. The long-term implications of complicated appendectomy remain largely unknown.
  
  
  METHODS
  In the present study, it was investigated whether patients with complicated appendicitis experienced more abdominal complaints after long-term follow-up when compared to uncomplicated cases. In addition, the influence of operation technique (open versus laparoscopic) was studied. A retrospective analysis of 1,481 appendectomies for acute appendicitis was performed in two centers from January 2000 until January 2006. Demographic data, operative reports, intraoperatively adhesions and complications, abdominal pain, and satisfaction were monitored. In total, 1,433 patients were invited to fill out a questionnaire with a median follow-up of 7.1 years. Questionnaires of 526 (37 %) patients were suitable for analysis.
  
  
  RESULTS
  Perforation, abdominal abscesses, or adhesions at initial operation did not result in more abdominal complaints when compared to appendectomy for uncomplicated acute appendicitis. Additionally, no significant differences in abdominal complaints were seen between laparoscopic and open techniques.
  
  
  CONCLUSIONS
  In conclusion, the results of our study show that after follow-up of 7 years, the incidence of abdominal complaints was not influenced by operative technique or whether acute appendicitis was complicated or not. This finding does not support a causative role for adhesions with regard to chronic abdominal complaints. Our data enables surgeons to inform their patients about the long-term results of appendectomy, whether it was complicated or not.
authors.affiliation: Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Dr. Molewaterplein 50, 3015, Rotterdam, The Netherlands. m.ditzel@erasmusmc.nl
authors.forename: M
authors.initials: M
authors.lastname: Ditzel
authors.forename: T M
authors.initials: TM
authors.lastname: van Ginhoven
authors.forename: J B C
authors.initials: JB
authors.lastname: van der Wal
authors.forename: W
authors.initials: W
authors.lastname: Hop
authors.forename: P P L O
authors.initials: PP
authors.lastname: Coene
authors.forename: J F
authors.initials: JF
authors.lastname: Lange
authors.forename: E
authors.initials: E
authors.lastname: van der Harst
mesh_terms: D018784:Abdominal Abscess / Q000150:complications* / Q000209:etiology; D015746:Abdominal Pain / Q000209:etiology*; D000328:Adult; D001062:Appendectomy / Q000009:adverse effects* / Q000379:methods; D001064:Appendicitis / Q000150:complications* / Q000601:surgery; D059350:Chronic Pain / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010538:Peritonitis / Q000150:complications* / Q000209:etiology; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors; D000267:Tissue Adhesions / Q000150:complications* / Q000209:etiology