scholarly journals Frequency of port-site infection in children undergoing laparoscopic appendectomy for uncomplicated appendicitis

2020 ◽  
Vol 1 (1) ◽  
pp. 37-40
Author(s):  
Muhammad Javed Khan ◽  
Jehangir Khan ◽  
Amjid Ali Shah ◽  
Muhammad Uzair
Keyword(s):  
Acute Appendicitis ◽  
Infection Rate ◽  
Laparoscopic Appendectomy ◽  
Pediatric Surgery ◽  
Port Site ◽  
Site Infection ◽  
Number Of Patients ◽  
Uncomplicated Appendicitis ◽  
The World ◽  
Safe Technique

Background: Laparoscopic appendectomy is being practiced throughout the world for the treatment of acute appendicitis in children and adults. The objective of this study was to determine the frequency of port sites infection in children undergoing laparoscopic appendectomy at our institution. Methods: The study was conducted at the Pediatric Surgery Unit of Lady Reading Hospital Peshawar from January 2014 to Jan 2015. All the patients with the diagnosis of acute appendicitis underwent a three-port laparoscopic appendectomy. Port-site infection was noted postoperatively. Results: Total number of patients in this study was 207 including 138 males (66.70%) and 69 (33.3%) females (M:F 2:1). The age ranged from 6 to 14 years, with mean age of 11 years ±2.096. The overall complications occurred in 39 (18.84%) patients. The port-site infection occurred in 33 (16%) patients. Port-site infection involved only the umbilical port sites and was superficial. Port-site infection was managed conservatively without any sequelae. Conclusion: Laparoscopic appendectomy is a safe technique in children with port-site infection rate of 16%. There is no morbidity as all the port-site infections occurred at umbilical port-site were superficial thus managed conservatively.

scholarly journals Higher Mortality and Infection Rate in a Region or Country Suggest a Longer Time of COVID-19 Disease Pandemic

2020 ◽  
Author(s):  
Tianshu Gu ◽  
Lan Yao ◽  
Tong Sun ◽  
Sara W. Day ◽  
Scott C. Howard ◽  
...  
Keyword(s):  
Infection Rate ◽  
Death Rate ◽  
Positive Relationship ◽  
Disease Duration ◽  
Strong Positive Correlation ◽  
Positive Correlation ◽  
Number Of Patients ◽  
The World ◽  
Total Death ◽  
R Value

Abstract In view of the fact that the 2019-nCoV has spread to most countries in the world, it is necessary to make scientific and well-founded predictions of the current pandemic situation caused by the virus worldwide, which are conducive to public, social and government responses that mitigate and appropriately address the pandemic. We collected data from provinces with more than 200 cases in China and from eight other countries. Our analyses showed that the disease duration has no correlation with the number of patients, with r = 0.184. The number of deaths was not correlated to the disease duration, with r = 0.242. However, a positive correlation between the days of disease duration and infection rate, with a r = 0.626. Furthermore, there is a strong positive correlation between the disease duration and total death rate, with a r = 0.707. Using death rate of first 25 days, we obtained a positive relationship with a r value of 0.597. Based on the data from first 25 days, the minimum and maximum days of COVID-19 pandemic duration of eight countries was estimated between days of 37 and 114 days.

scholarly journals Surgical site infection in Laparoscopic versus Open appendicectomy

2018 ◽  
Vol 7 (2) ◽  
pp. 39-43
Author(s):  
Ashok Koirala ◽  
Dipendra Thakur ◽  
Sunit Agrawal ◽  
Bhuwan Lal Chaudhary ◽  
Sagar Poudel
Keyword(s):  
Acute Appendicitis ◽  
Surgical Site Infection ◽  
Age Groups ◽  
Laparoscopic Appendicectomy ◽  
Surgical Removal ◽  
Age Group ◽  
Site Infection ◽  
Open Appendicectomy ◽  
Number Of Patients ◽  
The Mean

 Background: Acute appendicitis is very common surgical cause of acute abdomen and needs surgical removal either by laparoscopic or open appendicectomy. The aim of this study is to compare frequency of surgical site infection (SSI) in patients undergoing laparoscopic and open appendicectomy. Materials and Methods: The study was prospective study conducted in NMCTH, Biratnagar. Total 200 patients with diagnosis of acute appendicitis admitted through the emergency department of our hospital were included in the study. The patients were randomly allocated in two groups: Laparoscopic appendicectomy group (LA) and Open appendicectomy group (OA). Both groups underwent successful emergency appendicectomy. Wound infections in terms of surgical site infection (SSI) if present were recorded. All age groups and both sexes were included.  Results: Two hundred patients underwent appendicectomy, one hundred Laparoscopic appendicectomy (LA) and another hundred open appendicectomy (OA). The mean age of patients with acute appendicitis was 30.63±16.14 years with minimum of 6 years and maximum of 77 years. The highest number of patients were in age group of 10 to 20 years (29.5%). In LA group SSI noted in 3 patients (3%) whereas in OA group it was found in 12 patients (12%). Conclusion: Laparoscopic appendicectomy is better and offers great advantages in terms of SSI as compared to Open appendicectomy.  

scholarly journals Transumblical Single Incision Two-Port Laparoscopic Assisted Appendectomy: Early Experience in Paediatric Patients

2009 ◽  
Vol 22 (2) ◽  
pp. 289-294
Author(s):  
MA Nowshad ◽  
A Mostaque ◽  
SMA Shahid ◽  
HK Emrul
Keyword(s):  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Single Incision ◽  
Open Appendectomy ◽  
Operation Time ◽  
Randomized Controlled ◽  
Safe Technique ◽  
Port System ◽  
Laparoscopic Assisted ◽  
Additional Port

Laparoscopic appendectomy considered as superior alternative to open appendectomy. Usual laparoscopic appendectomy is performed with the three port system. In this study, we performed a unique single transumblical incision two-port laparoscopic assisted appendectomy with the aim to reduce postoperative port site complication as well as improving cosmesis and patients satisfaction. From January 2010, 32 patients were admitted with clinically diagnosed acute appendicitis and were randomly assigned to single transumblical incision two-port laparoscopic assisted appendectomy. Transumblical single incision two-port laparoscopic assisted appendectomy was attempted in all patients (9 males and 23 females) with an average age of 9.2 years. Transumblical single incision two-port laparoscopic assisted appendectomy was successfully completed in 31 patients. In one patient, another additional port required due to severe adhesion of the appendix. Mean operation time was 25.2 minutes (range, 17-38), and mean postoperative hospital stay was 1.Sdays (range 1-2). Postoperative complications (local pericaecal abscess) occurred in one case that was treated conservatively. Transumblical single incision two-port laparoscopic assisted appendectomy appears to be a feasible and safe technique for the treatment of acute appendicitis in the paediatric setting. It allows nearly scar less abdominal surgery. The true benefit of the technique should be assessed by randomized controlled trials.TAJ 2009; 22(1): 289-294

scholarly journals Irrigation Versus Suction Alone During Laparoscopic Appendectomy for Uncomplicated Acute Appendicitis

2020 ◽  
Vol 36 (1) ◽  
pp. 30-34
Author(s):  
Tae Gyeong Lee ◽  
Soomin Nam ◽  
Hyung Soon Lee ◽  
Jin Ho Lee ◽  
Young Ki Hong ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Appendicitis ◽  
Surgical Site Infection ◽  
Postoperative Complication ◽  
Laparoscopic Appendectomy ◽  
Operative Time ◽  
Multiple Logistic Regression Analysis ◽  
Operation Time ◽  
Site Infection ◽  
Uncomplicated Acute Appendicitis

Purpose: To compare the surgical outcomes of peritoneal irrigation versus suction alone during laparoscopic appendectomy and to identify the risk factors of surgical site infection in patients with uncomplicated acute appendicitis.Methods: Data from patients with uncomplicated acute appendicitis between January 2014 and March 2016 were reviewed. We compared the irrigation and suction alone groups with regard to the following parameters: postoperative complication incidence rate, length of hospital stay, operation time, time to flatus, time to diet commencement, and duration of postoperative antibiotic.Results: A total of 578 patients underwent laparoscopic appendectomy for uncomplicated acute appendicitis. Twenty-five patients were excluded from the analysis because of need for drain insertion, loss to follow-up, simultaneous surgery for another indication, presence of an appendix tumor, or pregnancy. A total of 207 patients (37.4%) had undergone irrigation, and 346 patients (62.6%) received suction alone during laparoscopic appendectomy. The preoperative fever rate was significantly higher in the irrigation group than in the suction alone group. Operative time was also significantly longer in the irrigation group than in the suction alone group (53.8 ± 18.5 minutes vs. 57.8 ± 21.4 minutes, P = 0.027). The postoperative complication rate was higher in the irrigation group than in the suction alone group (4.5% vs. 12.6%, P = 0.001). Multiple logistic regression analysis showed that irrigation and preoperative fever were risk factors for surgical site infection after laparoscopic appendectomy for uncomplicated acute appendicitis.Conclusion: There is no advantage to irrigating the peritoneal cavity over suction alone during laparoscopic appendectomy for uncomplicated acute appendicitis. Irrigation may actually prolong the operative time and therefore be detrimental.

Treatment of Acute Appendicitis in Geriatric Patients – Literature Review

2016 ◽  
Vol 88 (3) ◽  
Author(s):  
Anna Kot ◽  
Jakub Kenig ◽  
Piotr Wałęga
Keyword(s):  
Acute Appendicitis ◽  
Antibiotic Therapy ◽  
Laparoscopic Appendectomy ◽  
Age Groups ◽  
Length Of Hospital Stay ◽  
The Elderly ◽  
Independent Method ◽  
Number Of Patients ◽  
Pubmed Database ◽  
American Society

AbstractDemographic changes associated with the aging population mean that surgeons increasingly have contact and make decisions about treating patients from the oldest age groups.The aim of the study was to review the literature concerning the treatment of acute appendicitis in patients over the age of 60 years old.Material and methods. A review of the literature published in the years 2000-2015 has been carried out using the PubMed database. The initial number of results corresponding to the query in English, „appendicitis (MeSH) AND elderly (MeSH)” was 260. Selection based on the titles, abstracts, and eventually whole articles, ultimately resulted in 11 papers concerning the treatment of appendicitis in patients above 60 years of age.Results. Nine papers were retrospective and 2 were prospective. In total, the studies included 82,852 patients. Laparoscopic appendectomy was associated with a lower mortality rate, a smaller number of postoperative complications and a shorter length of hospital stay, which led to it being recommended by most authors. Four of the ten papers demonstrated that the patients who were qualified for laparoscopic surgery had less comorbidity and were in a lower ASA (American Society of Anaesthesiology) category. Antibiotic therapy as an independent method was assessed in one study in a group of elderly people, on a selected group of 26 patients, and its effectiveness was shown to be 70%. Most studies, however, are highly heterogeneous which significantly hindered comparisons.Conclusions. Currently, laparoscopic appendectomy seems to be the treatment of choice in the elderly with acute appendicitis. Antibiotic therapy, as an independent method of treatment of acute appendicitis, cannot currently be recommended. However, further, prospective, and better-designed studies are needed, involving a larger number of patients, and primarily dedicated to the elderly.

scholarly journals A comparative study on surgical site infection in cases of open and laparoscopic appendicectomy

2018 ◽  
Vol 5 (10) ◽  
pp. 3309
Author(s):  
Priyansh Pandey ◽  
Manish M. Swarnkar ◽  
S. C. Jain
Keyword(s):  
Acute Appendicitis ◽  
Blood Cell ◽  
Surgical Site Infection ◽  
Clinical Features ◽  
White Blood Cell ◽  
Laparoscopic Appendectomy ◽  
Open Appendectomy ◽  
Laparoscopic Appendicectomy ◽  
Open Approach ◽  
Site Infection

Background: Diagnosis of acute appendicitis is mostly based on clinical features pointing towards appendicitis. Several biochemical parameters, such as the white blood cell (WBC) count, and neutrophil percentage, are currently used to aid clinical diagnosis.  Without immediate surgery, appendicitis may progress to perforation of the appendix. This study was carried out to determine rate of SSI in open versus laparoscopic appendicectomy for acute appendicitis and to identify independent risk factors for SSI.Methods: Appendicitis is a common cause of pain in right iliac fossa worldwide. The present study was carried out in the Department of General Surgery, Acharya Vinoba Bhave Rural Hospital, affiliated to Jawaharlal Nehru Medical College, Sawangi, Wardha, from August 2015 to July 2017. This study was conducted after the due clearance from Institutional Ethical committee. Total 132 patients admitted to the surgery ward with acute lower abdominal pain with clinical features of acute appendicitis on clinical examination, were studied prospectively.Results: In the present study, maximum patients were seen in less than 20 years of age and next commonest age group of presentation was 21-30 years. The male to female sex ratio was 1:1.3 in the laparoscopic appendectomy group while in the open appendectomy group was 1.81:1. The incidence of complicated intra-operative findings and mean white blood cell count was more in the open appendectomy group. The mean operative time, days for use of analgesics, time taken to return to soft diet and length of hospital stay for laparoscopic appendectomy group was less than the open appendectomy group. There were more cases of surgical site infection in the patients operated by open approach than laparoscopic approach.Conclusions: Wound class II versus III and NNIS index were found to be significantly associated with surgical site infection.

scholarly journals Evaluation of laparoscopic appendectomy proficiency in the management of acute appendicitis based on anatomy and pathologies

2021 ◽  
Vol 25 (2) ◽  
pp. 551-559
Author(s):  
Suhel Najjar ◽  
Jawher Aumer ◽  
Paiman Muhamad
Keyword(s):  
Postoperative Pain ◽  
Postoperative Complications ◽  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Conversion Rate ◽  
Evaluation Studies ◽  
Site Infection ◽  
Pelvic Hematoma ◽  
Operation Duration ◽  
Significant Superiority

Background and objective: Laparoscopic appendectomy entered a controversial dilemma for choosing a perfect approach for appendectomy. Evaluation studies may resolve this controversy. This study aimed to evaluate laparoscopic appendectomy proficiency depending on anatomy and pathology. Methods: A total of 148cases managed by laparoscopic appendectomy were studied from 2014 to 2015.These cases were diagnosed clinically and by investigations. Parameters studied were operation duration, conversion rate, complications, associated pathology, rehabilitation, and histopathology. Results: By laparoscopy, the anatomical position of the appendix was easily recognized in 83.78%of cases, while the position of 16.22 %of cases was difficult because of the hidden appendix by adhesions, complications, and technical causes. The operation duration ranged between 34 and 60 minutes. Associated pathologies were demonstrated in 8% of cases. Regarding discharge from the hospital, 30% were on the same day, 50% on the first postoperative day, and 20% on the second postoperative day. Postoperative complications were 3% due to pelvic hematoma, port site infection, and bleeding. Postoperative pain was experienced in 3% of cases. The conversion rate was 4.7%. Rehabilitation was within 8-10 days. Conclusions: Laparoscopic appendectomy is safe and suitable for various anatomical positions of the inflamed appendix, suspicious, hidden, and in the presence of other pathologies with a properly placed port can play diagnostic and therapeutic roles. Significant superiority of laparoscopic appendectomy was observed in this study for the management of acute appendicitis and its pathological consequences. The conversion rate was 4.7% due to other pathologies. Keywords: Laparoscopic; Appendectomy; Anatomy; Pathology.

scholarly journals A Comparative Study between the Outcome of Laparoscopic Appendectomy and Open Appendectomy in Children

2015 ◽  
Vol 5 (1) ◽  
pp. 25-29
Author(s):  
Nazmus Sakib Ferdous ◽  
Ashraf Ul Huq ◽  
Kaniz Hasina ◽  
Masuda Khatun
Keyword(s):  
Acute Appendicitis ◽  
Comparative Study ◽  
Laparoscopic Appendectomy ◽  
Operative Procedure ◽  
Open Appendectomy ◽  
Length Of Hospital Stay ◽  
Postoperative Pain Management ◽  
Developed Countries ◽  
Uncomplicated Appendicitis ◽  
Operative Findings

Background: Laparoscopic surgery for acute appendicitis in children has been proposed to have advantages over conventional surgery.Introduction: Appendicitis is the most common surgical emergency in childhood. 1 For decades, Open appendectomy (OA) has been the standard treatment for all forms of appendicitis with excellent results.2 Since its description in the early 1980s, laparoscopic appendectomy (LA) became an acceptable approach for simple appendicitis in children.3, 4, 5However, its role in the treatment of complicated appendicitis is controversial. Today, in developed countries about 8% of the population is appendectomized for acute appendicitis during their lifetime.7Materials and method: We are conducting a prospective comparative study with the intention to observe the outcome of 60 purposively selected patients of acute appendicitis in the Department of Pediatric Surgery, Dhaka Medical College & Hospital (DMCH), Dhaka, over a period of 12 months from October, 2013 to October, 2014. The patients are going to be divided into 2 groups by random sampling- Group A- OA Group (patients underwent open appendectomy) and Group B- LA Group (patients underwent laparoscopic appendectomy) for uncomplicated appendicitis. Children up to 14 years are planned to be selected as study subjects. All children are subjected to investigate for white blood cell (WBC) count, plain X- ray KUB region, urine R/E, preoperatively and to observe the amount of analgesics in postoperative pain management and cosmesis on first week, first month, and third month of operation. Structured questionnaire is used to collect information regarding pain, fever, other association preoperatively and operative procedure, duration of operation, per operative findings and post operative follow up. Informed written consent from parents or legal guardian is taken after describing the study objectives. Ethical clearance has been sought from the Ethical Committee of Dhaka Medical College.Results: Total 23 patients are studied till now, 16 in LA group and 7 in OA group. From this limited data we have seen that there is apparently minimum difference between two groups of study population regarding postoperative outcomes.Conclusion: This is an on-going study. Definite conclusion could not be drawn at this preliminary stage. Laparoscopic appendectomy for uncomplicated appendicitis in children is feasible and safe. It is associated with a significantly less use of post operative pain killer, lower incidence of wound infection, and reduced length of hospital stay when compared with patients who had open appendectomy.J. Paediatr. Surg. Bangladesh 5(1): 25-29, 2014 (January)

scholarly journals Single Incision Laparoscopic Surgery for Acute Appendicitis: Feasibility in Pediatric Patients

2010 ◽  
Vol 2010 ◽  
pp. 1-3 ◽  
Author(s):  
Andre Chow ◽  
Omer Aziz ◽  
Sanjay Purkayastha ◽  
Ara Darzi ◽  
Paraskevas Paraskeva
Keyword(s):  
Patient Satisfaction ◽  
Laparoscopic Surgery ◽  
Acute Appendicitis ◽  
Gold Standard ◽  
Pediatric Patients ◽  
Single Incision ◽  
Single Incision Laparoscopic Surgery ◽  
Pediatric Setting ◽  
Uncomplicated Appendicitis ◽  
Safe Technique

Background. Laparoscopic appendicectomy is accepted by many as the gold standard approach for the treatment of acute appendicitis. The use of Single Incision Laparoscopic Surgery (SILS) has the potential of further reducing postoperative port site complications as well as improving cosmesis and patient satisfaction. Method. In this paper we report our experience and assess the feasibility of SILS appendicectomy in the pediatric setting. Results. Five pediatric patients with uncomplicated appendicitis underwent SILS appendicectomy. There were no significant intraoperative or postoperative complications. All patients were discharged within 24 hours. Conclusions. The use of Single Incision Laparoscopic Surgery appears to be a feasible and safe technique for the treatment of uncomplicated appendicitis in the pediatric setting. Further studies are warranted to fully investigate the potential advantages of this new technique.

Impact of wound irrigation during laparoscopic appendectomy on surgical site infection in acute appendicitis: a multicenter retrospective analysis

2020 ◽  
Author(s):  
Soomin Nam ◽  
Youn Young Park ◽  
Yun Tae Jung ◽  
Chinock Cheong
Keyword(s):  
Acute Appendicitis ◽  
Surgical Site Infection ◽  
Laparoscopic Appendectomy ◽  
Perforated Appendicitis ◽  
Operation Time ◽  
Skin Closure ◽  
Site Infection ◽  
Wound Irrigation ◽  
Saline Irrigation ◽  
Postoperative Fever

Abstract Background Surgical site infection (SSI) is one of the major complications after appendectomy. Among the many efforts to reduce variable risk factors, subcutaneous wound irrigation has been reported in some abdominal surgeries. However, there are no relevant literatures regarding patients who underwent laparoscopic appendectomy. This study aimed to determine the effect of wound irrigation before skin closure when performing laparoscopic appendectomy. Methods We included patients who had undergone laparoscopic appendectomy due to acute appendicitis from March 2017 to October 2019 from three hospitals. Clinical data of 333 patients were retrospectively collected, and we divided 333 patients into three groups according to the method of wound irrigation: no irrigation (n = 93), saline irrigation (n = 144), and povidone-iodine (PI) (n = 96) groups. Results A total of 15 patients (4.5%) were diagnosed with SSI within postoperative 30 days. There was no difference in the SSI rates (4.3% vs. 5.1% vs. 4.5%, p = 0.953). None of the factors were associated with SSI among the variables (sex, age, ASA, perforated appendicitis, preoperative WBC and hemoglobin levels, operation time, wound irrigation, type of wound closure material, and preoperative and postoperative fever). Conclusions Wound irrigation did not affect the SSI rate in patients who underwent laparoscopic appendectomy.

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