Laparoscopic appendectomy for complicated acute appendicitis does not result in increased surgical complications

Objective: The choice of laparoscopic technique in the treatment of complicated acute appendicitis (CAA) harbours debatable evidence because of higher rates of surgical complications such as postoperative intraabdominal abscess (POIIA). The aim of this study is to compare postoperative results of appendiceal stump (AS) ligation and its burial into the cecum using laparoscopic or open surgical techniques in patients with CAA. Method: This is a single-center and retrospective analysis of patients with CAA operated between May 2018 and April 2020. AS was intracorporeally knotted with silk and buried in the cecum with a purse-string suture (PSS). The patients were divided into open appendectomy (OA) and laparoscopic appendectomy (LA) groups. Data concerning demographic characteristics, intraoperative variables, hospital stay, surgical complications, morbidities, and postoperative findings were compared. Results: A total of 66 patients including 36 patients (54.54%) underwent LA and 30 patients had OA were enrolled in the study. Partial resection of cecum was performed in one patient in the OA group and two patients in the LA group with the help of a stapler due to cecal floor necrosis. The operative time and duration of hospital stay were significantly shorter in the LA group compared to the OA group. Surgical site infection and POIAA were significantlymore frequent in the OA group (p<0.001). Conclusion: In acute complicated appendicitis, laparoscopic method can be applied as an effective method by closing the appendiceal stump and burying into the cecum with a purse-string suture.

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The value of post-operative antibiotic therapy after laparoscopic appendectomy for complicated acute appendicitis: a prospective, randomized, double-blinded, placebo-controlled phase III study (ABAP study)

Trials ◽

10.1186/s13063-020-04411-1 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

C. Sabbagh ◽

N. Siembida ◽

H. Dupont ◽

M. Diouf ◽

J. L. Schmit ◽

...

Keyword(s):

Acute Appendicitis ◽

Antibiotic Therapy ◽

Laparoscopic Appendectomy ◽

Phase Iii ◽

Phase Iii Study ◽

Double Blinded ◽

Complicated Acute Appendicitis

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Low-Cost Single-Port Laparoscopic Appendectomy Using Gloveport for Complicated Acute Appendicitis: A Comparative Study

Journal of the American College of Surgeons ◽

10.1016/j.jamcollsurg.2020.07.191 ◽

2020 ◽

Vol 231 (4) ◽

pp. S101

Author(s):

Mauricio Pedraza Ciro ◽

Luis Felipe Cabrera Vargas ◽

Jean Andre Pulido Segura

Keyword(s):

Acute Appendicitis ◽

Comparative Study ◽

Laparoscopic Appendectomy ◽

Single Port ◽

Low Cost ◽

Complicated Acute Appendicitis

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Study on the Feasibility and the Safety of Hem-o-lok Clipping for Complicated Acute Appendicitis during Laparoscopic Appendectomy

Journal of Minimally Invasive Surgery ◽

10.7602/jmis.2013.16.1.6 ◽

2013 ◽

Vol 16 (1) ◽

pp. 6-10

Author(s):

Ki Hyun Kim ◽

Si Hak Lee ◽

Kwang Ho Yang ◽

Sun Hwi Hwang

Keyword(s):

Acute Appendicitis ◽

Laparoscopic Appendectomy ◽

Complicated Acute Appendicitis

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Tactical approaches to the surgical treatment of patients with complicated forms of acute appendicitis and abdominal sepsis with a high risk of cardiopulmonary insufficiency

Modern medical technologies ◽

10.34287/mmt.2(41).2019.24 ◽

2019 ◽

Vol 41 part 2 (2) ◽

pp. 44-48

Author(s):

B. S. Zaporozhchenko ◽

Khasan Yakhia ◽

I. E. Borodaev ◽

V. N. Kachanov ◽

A. A. Vasiliev

Keyword(s):

High Risk ◽

Acute Appendicitis ◽

Laparoscopic Appendectomy ◽

Standard Procedure ◽

Abdominal Cavity ◽

Open Appendectomy ◽

Abdominal Sepsis ◽

Group I ◽

Almost All ◽

Complicated Acute Appendicitis

Purpose of the study. To determine the feasibility and effectiveness of the laparoscopic method of treatment of patients with complicated forms of acute appendicitis. in patients with high risk of cardiopulmonary failure and to determine the indications for the use of various methods of laparoscopic appendectomy. Materials and methods. The result of treatment of 67 patients with acute appendage with high risky cardiopulmonary insufficiency. Of these, 10 patients (14,9%) were diagnosed with sepsis. The patients were divided into two groups: Group I: 29 (43,3%) patients with complicated acute appendicitis, with a high risk of cardiopulmonary insufficiency, who underwent open appendectomy. Open appendectomy was performed according to the standard procedure from the Volkovich-Dyakonov (Mac-Burney) incision in 19 (65,5%) patients, in 10 (34,5%) median laparotomy. Group II: 38 (56,7%) patients with complicated acute appendicitis who underwent laparoscopic appendectomy, and drainage of the abdominal cavity. Classical laparoscopic surgery with the imposition of pneumoperitoneum was performed in 20 (29,8%) patients and using the laparolifting method in 18 (26,9%) patients Results. 38 (56,7%) patients were operated on using laparoscopic techniques. During laparoscopic interventions, intraoperative revision and appendectomy were performed. This technique is absolutely safe, reliable and affordable in the performance of most surgeons. Conclusions. Laparoscopic appendectomy with complicated forms of acute appendicitis can be performed in almost all patients with acute appendicitis with a high risk of cardiopulmonary insufficiency. Keywords: acute appendicitis, complicated appendicitis, appendectomy, cardiopulmonary insufficiency, laparoscopy. sepsis.

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