title: Management of postoperative intraabdominal abscess in laparoscopic versus open appendectomy.
abstract: BACKGROUND
  Complicated appendicitis (gangrenous or perforated appendicitis) is a risk for postoperative intraabdominal abscess, but management of intraabdominal abscess may differ between laparoscopic and open appendectomy.
  
  
  METHODS
  We reviewed 67 patients who underwent appendectomy for complicated appendicitis, including 26 who received laparoscopic appendectomy (LA group) and 41 who underwent open appendectomy (OA group). The operation was performed under general anesthesia in all 26 patients in the LA group and in 10 (24%) in the OA group. Patient characteristics, operative factors, and postoperative complications (especially postoperative intraabdominal abscess) were compared between the two groups. Management of postoperative intraabdominal abscess was also investigated.
  
  
  RESULTS
  Postoperative intraabdominal abscess occurred in 3 patients (12%) in the LA group and in 10 (24%) in the OA group (p = 0.23). All 3 patients in the LA group were treated conservatively. Of the 10 patients in the OA group, 6 were treated conservatively, but 4 needed a reoperation, including 3 who had undergone right pararectal skin incision under spinal analgesia and in whom sufficient irrigation was not possible because anesthesia had worn off.
  
  
  CONCLUSIONS
  Our results suggest that insertion of abdominal drainage may be appropriate treatment for intraabdominal abscess after laparoscopic appendectomy. Light anesthesia may induce residual abscess in open appendectomy performed under spinal analgesia.
authors.affiliation: Department of Surgery, Ishikiriseiki Hospital, Higashiosaka City, Japan. m8827074@msic.med.osaka-cu.ac.jp
authors.forename: Shogo
authors.initials: S
authors.lastname: Tanaka
authors.forename: Kanji
authors.initials: K
authors.lastname: Ishihara
authors.forename: Takahiro
authors.initials: T
authors.lastname: Uenishi
authors.forename: Ryoya
authors.initials: R
authors.lastname: Hashiba
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Kurashima
authors.forename: Kohichi
authors.initials: K
authors.lastname: Ohno
authors.forename: Sayaka
authors.initials: S
authors.lastname: Tanaka
authors.forename: Masahiko
authors.initials: M
authors.lastname: Ohsawa
authors.forename: Takatsugu
authors.initials: T
authors.lastname: Yamamoto
mesh_terms: D018784:Abdominal Abscess / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015360:Analgesia, Epidural; D000768:Anesthesia, General / Q000009:adverse effects; D001062:Appendectomy / Q000009:adverse effects* / Q000379:methods; D001064:Appendicitis / Q000601:surgery*; D002648:Child; D004322:Drainage; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult