Postoperative antibiotic use and the incidence of intra-abdominal abscess in the setting of suppurative appendicitis: a retrospective analysis

Bae, Esther; Dehal, Ahmed; Franz, Vanessa; Joannides, Michael; Sakis, Nicholas; Scurlock, Joshua; Nguyen, Patrick; Hussain, Farabi

doi:10.1016/j.amjsurg.2016.09.010

Cited by 5 publications

(1 citation statement)

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“…Although preoperative antibiotics have been shown to reduce complication rates, there is a lot of controversy as to whether they are of benefit in the postoperative period. The preventative effect of antibiotics in uncomplicated appendicitis is often negligible [24, 25], and, similarly, their use is being reduced in complicated cases as well [26]. Still, no good quality randomized controlled trials assess this aspect of perioperative care in complicated appendicitis.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for intraabdominal abscess formation after laparoscopic appendectomy - results from the Pol-LA (Polish Laparoscopic Appendectomy) multicenter large cohort study.

Lasek

Pędziwiatr

Wysocki

et al. 2018

Videosurgery and Other Miniinvasive Techniques

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IntroductionAccording to meta-analyses laparoscopic appendectomy is associated with many benefits. However, in comparison to open surgery an increased rate of intraabdominal abscesses (IAA) has been reported. Identification of predictive factors for this complication may help to identify patients with higher risk of IAA.AimTo identify potential risk factors for intraabdominal abscess after laparoscopic appendectomy (LA).Material and methodsEighteen surgical units in Poland and Germany submitted data of patients undergoing LA to the online web-based database created by the Polish Videosurgery Society of the Association of Polish Surgeons. It comprised 31 elements related to the pre-, intra- and postoperative period. Surgical outcomes were compared among the groups according to occurrence of IAA. Univariate and multivariate logistic regression models were used to identify potential risk factors for IAA.Results4618 patients were included in the analysis. IAA were found in 51 (1.10%) cases. Although several risk factors were found in univariate analysis, in the multivariate model, only the presence of complicated appendicitis was statistically significant (OR = 2.98, 95% CI: 1.11–8.04). Moreover, IAA has a significant influence on postoperative reintervention rate (OR = 126.95, 95% CI: 67.98–237.06), prolonged length of stay > 8 days (OR = 41.32, 95% CI: 22.86–74.72) and readmission rate (OR = 33.89, 95% CI: 18.60–34.73).ConclusionsIntraabdominal abscesses occurs relatively rarely after LA. It is strongly associated with complicated appendicitis. Occurrence of this complication has a great influence on the postoperative period and due to the nature of its treatment is associated with the need for reintervention, prolonged length of stay and by extension possible readmission.

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Section: Discussionmentioning

confidence: 99%