Comparison of intra-abdominal abscess formation following laparoscopic and open appendicectomy in children

Ramesh Nataraja, Ashwath Bandi, Simon A. Clarke, Munther J. Haddad

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background: Controversy exists over the association between laparoscopic (LA) and open appendicectomy (OA) and the formation of postoperative intra-abdominal abscesses (IAAs). Our aim was to compare the outcome following these two techniques in a pediatric population. Subjects and Methods: A retrospective data collection was carried out on all patients undergoing either an LA or OA at a single center over a 26-month period. Patients were identified from a hospital database and theater records. An intra-abdominal abscess was defined as recorded pyrexia, a raised inflammatory marker, and radiologic confirmation of an intra-abdominal collection. Other parameters studied included wound infection, appendiceal perforation, hospital stay, conversion rate, microbiology, histology, radiologic investigation, and serologic analysis. Data were analyzed from using Fisher's exact and Mann-Whitney tests, as appropriate. A P-value of <0.05 was considered significant. Results: Two hundred children were identified, with a median follow-up of 18 months. Forty patients underwent an LA and 151 an OA. Nine patients underwent interval appendicectomy and were not included in the final data. There was no difference between the two groups in terms of baseline demographics, duration of stay (P = 0.5), or wound infection (P=1.0). The incidence of an intra-abdominal abscess was 0 of 40 (0%) in the laparoscopic group and 5 of 151 (3.3%) in the open group, although this was not statistically significant (P = FOR 0.8). The median time to postoperative diagnosis of abscess was 9 days (range, 8-11). A consultant was present in more laparoscopic procedures than open (88 versus 24%; P = FOR 0.0001). Conclusions: The rate of intra-abdominal abscess formation was not significantly different following either an LA or OA, although there were no intra-abdominal abscesses observed in the laparoscopic group. Further investigation could address this finding more accurately in a randomized, controlled trial.

Original languageEnglish
Pages (from-to)391-394
Number of pages4
Journal Journal of Laparoendoscopic and Advanced Surgical Techniques: Part A
Volume20
Issue number4
DOIs
Publication statusPublished - 1 May 2010

Cite this

@article{b6f69c4a6848450eb47cac9f71a99a8c,
title = "Comparison of intra-abdominal abscess formation following laparoscopic and open appendicectomy in children",
abstract = "Background: Controversy exists over the association between laparoscopic (LA) and open appendicectomy (OA) and the formation of postoperative intra-abdominal abscesses (IAAs). Our aim was to compare the outcome following these two techniques in a pediatric population. Subjects and Methods: A retrospective data collection was carried out on all patients undergoing either an LA or OA at a single center over a 26-month period. Patients were identified from a hospital database and theater records. An intra-abdominal abscess was defined as recorded pyrexia, a raised inflammatory marker, and radiologic confirmation of an intra-abdominal collection. Other parameters studied included wound infection, appendiceal perforation, hospital stay, conversion rate, microbiology, histology, radiologic investigation, and serologic analysis. Data were analyzed from using Fisher's exact and Mann-Whitney tests, as appropriate. A P-value of <0.05 was considered significant. Results: Two hundred children were identified, with a median follow-up of 18 months. Forty patients underwent an LA and 151 an OA. Nine patients underwent interval appendicectomy and were not included in the final data. There was no difference between the two groups in terms of baseline demographics, duration of stay (P = 0.5), or wound infection (P=1.0). The incidence of an intra-abdominal abscess was 0 of 40 (0{\%}) in the laparoscopic group and 5 of 151 (3.3{\%}) in the open group, although this was not statistically significant (P = FOR 0.8). The median time to postoperative diagnosis of abscess was 9 days (range, 8-11). A consultant was present in more laparoscopic procedures than open (88 versus 24{\%}; P = FOR 0.0001). Conclusions: The rate of intra-abdominal abscess formation was not significantly different following either an LA or OA, although there were no intra-abdominal abscesses observed in the laparoscopic group. Further investigation could address this finding more accurately in a randomized, controlled trial.",
author = "Ramesh Nataraja and Ashwath Bandi and Clarke, {Simon A.} and Haddad, {Munther J.}",
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Comparison of intra-abdominal abscess formation following laparoscopic and open appendicectomy in children. / Nataraja, Ramesh; Bandi, Ashwath; Clarke, Simon A.; Haddad, Munther J.

In: Journal of Laparoendoscopic and Advanced Surgical Techniques: Part A, Vol. 20, No. 4, 01.05.2010, p. 391-394.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - Comparison of intra-abdominal abscess formation following laparoscopic and open appendicectomy in children

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AU - Bandi, Ashwath

AU - Clarke, Simon A.

AU - Haddad, Munther J.

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N2 - Background: Controversy exists over the association between laparoscopic (LA) and open appendicectomy (OA) and the formation of postoperative intra-abdominal abscesses (IAAs). Our aim was to compare the outcome following these two techniques in a pediatric population. Subjects and Methods: A retrospective data collection was carried out on all patients undergoing either an LA or OA at a single center over a 26-month period. Patients were identified from a hospital database and theater records. An intra-abdominal abscess was defined as recorded pyrexia, a raised inflammatory marker, and radiologic confirmation of an intra-abdominal collection. Other parameters studied included wound infection, appendiceal perforation, hospital stay, conversion rate, microbiology, histology, radiologic investigation, and serologic analysis. Data were analyzed from using Fisher's exact and Mann-Whitney tests, as appropriate. A P-value of <0.05 was considered significant. Results: Two hundred children were identified, with a median follow-up of 18 months. Forty patients underwent an LA and 151 an OA. Nine patients underwent interval appendicectomy and were not included in the final data. There was no difference between the two groups in terms of baseline demographics, duration of stay (P = 0.5), or wound infection (P=1.0). The incidence of an intra-abdominal abscess was 0 of 40 (0%) in the laparoscopic group and 5 of 151 (3.3%) in the open group, although this was not statistically significant (P = FOR 0.8). The median time to postoperative diagnosis of abscess was 9 days (range, 8-11). A consultant was present in more laparoscopic procedures than open (88 versus 24%; P = FOR 0.0001). Conclusions: The rate of intra-abdominal abscess formation was not significantly different following either an LA or OA, although there were no intra-abdominal abscesses observed in the laparoscopic group. Further investigation could address this finding more accurately in a randomized, controlled trial.

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DO - 10.1089/lap.2009.0193

M3 - Article

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JO - Journal of Laparoendoscopic and Advanced Surgical Techniques: Part A

JF - Journal of Laparoendoscopic and Advanced Surgical Techniques: Part A

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