Four decades of laparoscopic appendectomy. does it have the same role in the management algorithm of a postappendectomy abscess?

• Published in: The Egyptian journal of surgery : official organ of the Egyptian Society of Surgeons = Majallat al-jirāhah al-Misrīyah Vol. 42; no. 4; pp. 1017 - 1024
• Main Authors: Osman, Tarek A., Fouad, Ramy H., Guirguis, Nader N., Shoka, Ahmed A.
• Format: Journal Article
• Language: English
• Published: India Wolters Kluwer - Medknow 01.10.2023; Medknow Publications and Media Pvt. Ltd
• Edition: 3
• Subjects: Algorithms; Laparoscopic surgery; Laparoscopy; Medical research; Medicine, Experimental; Metronidazole; Original articles; postappendectomy abscess; laparoscopic appendectomy; post-appendectomy complications; intra-abdominal collection; abdominal drainage
• ISSN: 1110-1121; 1687-7624; 1687-7624
• DOI: 10.4103/ejs.ejs_204_23

Background/Objective Postappendectomy abscess (PAA) is the most controversial complication after appendectomy. We aimed to identify the actual incidence of PAA and to compare the success rate of different lines of treatment both in adult and pediatric age groups in our institute. Methods A prospective study was conducted on patients who had a radiologically confirmed PAA. They were subdivided into adults (group A) and children (group B). A stepwise approach was used for the management of the PAA. The success rate of each line of treatment was recorded and compared between both groups. Results Five hundred twenty appendectomy patients were included in this study (321 adult and 199 pediatric patients). In group A, 14 (4.36%) patients had a PAA in comparison to 9 (4.52%) children in group B. In group A, the success rate of both the medical and surgical treatment was 66.7%, whereas the radiological drainage was successful in the three cases. In group B, medical treatment was successful in 83.3% and the patient who failed medical treatment was drained laparoscopically. The remaining three cases were radiologically drained. Conclusion This is the first trial to compare the success rate of different lines of treatment of PAA between adult and pediatric patients. Our results conclude that there is no statistically significant difference between the success rate of each line of treatment.