Risk Factors for Postoperative Intra-Abdominal Abscess after Laparoscopic Appendectomy: Analysis for Consecutive 1,817 Experiences.
BACKGROUND
Possible risk factors for postoperative intra-abdominal abscess (IAA) formation after laparoscopic appendectomy (LA) remain controversial. A perforated appendicitis, diabetes mellitus, peritoneal irrigation, obesity and age are considered to be possible risk factors for postoperative IAA, but the existing evidence is insufficient. This study aimed to identify the risk factors for IAA formation in patients receiving LA.


METHODS
Between January 2010 and December 2013, 1,817 patients who underwent 3-port LA were enrolled in this study. Patients were classified into 2 groups according to the development of postoperative IAA, and the differences between the groups were analyzed.


RESULTS
The incidence of IAA after LA was 1.5%, and the only identified risk factor for IAA was peritoneal irrigation. On logistic regression analysis of those patients who received peritoneal irrigation, suppurative appendicitis and non-placement of the peritoneal drain were found to be significant risk factors for the development of IAA.


CONCLUSIONS
Peritoneal irrigation in a case of abdomen contamination was shown to be a risk factor for the development of postoperative IAA after LA. When peritoneal irrigation is performed, surgeons should consider using peritoneal drainage and postoperative antibiotics (including anti-anaerobic antibiotics) to prevent postoperative IAA formation.
Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Jinbeom
J
Cho
Ilyoung
I
Park
Dosang
D
Lee
Kiyoung
K
Sung
Jongmin
J
Baek
Junhyun
J
Lee
D018784:Abdominal Abscess / Q000453:epidemiology / Q000209:etiology*; D000328:Adult; D000368:Aged; D001062:Appendectomy / Q000379:methods; D001064:Appendicitis / Q000601:surgery*; D005260:Female; D006801:Humans; D015994:Incidence; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome