| Intra-abdominal collections following laparoscopic versus open appendicectomy: an experience of 516 consecutive cases at a district general hospital. | |
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MedLine Citation:
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PMID: 23355169 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: The objective of this study is to evaluate the incidence of intra-abdominal collections (IACs) in all patients undergoing laparoscopic (LA) and open appendicectomy (OA) from April 2009 to October 2011 in a district general hospital with expertise in minimally invasive surgery (MIS). METHODS: A retrospective review of all patients undergoing appendicectomy in the specified time period was carried out. IACs were identified from various in-hospital data resources. Severity of appendicitis was assessed from histology reports. RESULTS: 516 patients were identified, of whom 242 (47 %) underwent OA and 274 (53 %) LA. Twenty-six (5 %) patients were found to have IACs postoperatively. Fifteen (5.5 %) IACs were identified in the laparoscopic group and 11 (4.5 %) in the open group. There was no statistically significant difference in the risk of developing IACs in open versus laparoscopic groups [odds ratio (OR) 1.22, confidence interval (CI) 0.55-2.70, P = 0.63]. Patients were twelve times more likely to develop IACs with an appendix identified as being necrotic or perforated on histology (OR 12.24, CI 5.29-28.32, P < 0.0001). There was a trend towards shorter total hospital stay in the LA (3.58 days, CI 3.0-4.1 days) compared with OA (4.31 days, CI 3.7-4.9 days, P = 0.082) group, although this was not statistically significant. CONCLUSIONS: Increased rates of IAC following LA have been identified in some studies. Our series shows that, in a centre with adequate MIS experience, the IAC rate following LA is comparable to that of the open approach and should not deter surgeons with adequate support and resources. |
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Authors:
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Daniel G G Wilson; Amanda K Bond; Nikhil Ladwa; Muhammad S Sajid; Mirza K Baig; Parvinderpal Sains |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2013-1-26 |
Journal Detail:
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Title: Surgical endoscopy Volume: - ISSN: 1432-2218 ISO Abbreviation: Surg Endosc Publication Date: 2013 Jan |
Date Detail:
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Created Date: 2013-1-28 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8806653 Medline TA: Surg Endosc Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Department of General & Laparoscopic Colorectal Surgery, Worthing Hospital, Worthing, West Sussex, BN11 2DH, UK, d.wilson@doctors.org.uk. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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