title: Comparison of the outcomes of laparoscopic and open approaches in the treatment of periappendiceal abscess diagnosed by radiologic investigation.
abstract: BACKGROUND
  Although laparoscopic appendectomy (LA) has been performed widely, the role of LA for complicated appendicitis remains controversial, and its role for periappendiceal abscess (PA) remains undefined. This study compared the clinical outcomes of LA and open appendectomy (OA) for PA diagnosed by radiologic investigation.
  
  
  METHODS
  We conducted a retrospective review of 84 patients who underwent surgery for PA diagnosed by radiologic investigation between 2010 and 2013. Twenty-five patients underwent LA, and the remaining patients underwent OA. Patient characteristics, operative outcomes, and surgical complications were compared between the two groups.
  
  
  RESULTS
  Three patients required conversion from LA to OA (12%). There were no significant differences in the overall complication (28% versus 25.4%; P=.8), wound infection (15.3% versus 4%; P=.27), stump leakage (4% versus 1.7%; P=.51), and postoperative ileus (4% versus 8.5%; P=.66) rates between the groups. The incidence of intraabdominal abscess (IAA) was significantly higher in the LA group (20% versus 3.4%; P=.02). In multivariate analysis, the risk factors for IAA were duration of drainage (P=.04) and type of operation (P=.006). The major complications rate was 2.4% in the total cohort, and the rate was significantly higher in the LA group (8% versus 0%; P=.02).
  
  
  CONCLUSIONS
  For patients with PA, the rates of overall complications, wound infection, stump leakage, and postoperative ileus were similar for both procedures. However, LA resulted in a significantly higher incidence of IAA and major complications than OA.
authors.affiliation: 1 Department of Surgery, Eulji General Hospital, Eulji University College of Medicine , Seoul, South Korea .
authors.forename: Sunchul
authors.initials: S
authors.lastname: Yeom
authors.forename: Min Sung
authors.initials: MS
authors.lastname: Kim
authors.forename: Seulkee
authors.initials: S
authors.lastname: Park
authors.forename: Taeil
authors.initials: T
authors.lastname: Son
authors.forename: Yoon Young
authors.initials: YY
authors.lastname: Jung
authors.forename: Seung Ah
authors.initials: SA
authors.lastname: Lee
authors.forename: Yeon Soo
authors.initials: YS
authors.lastname: Chang
authors.forename: Dong Hee
authors.initials: DH
authors.lastname: Kim
authors.forename: Joon Kil
authors.initials: JK
authors.lastname: Han
mesh_terms: D018784:Abdominal Abscess / Q000000981:diagnostic imaging / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D001062:Appendectomy / Q000009:adverse effects / Q000379:methods*; D001064:Appendicitis / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D011859:Radiography; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome