eISSN: 2299-0054
ISSN: 1895-4588
Videosurgery and Other Miniinvasive Techniques
Current issue Archive Videoforum Manuscripts accepted About the journal Supplements Abstracting and indexing Subscription Contact Instructions for authors
SCImago Journal & Country Rank

vol. 14
Original paper

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

Anna Lasek, Michał Pędziwiatr, Michał Wysocki, Judene Mavrikis, Piotr Myśliwiec, Tomasz Stefura, Maciej Bobowicz, Piotr Major, Mateusz Rubinkiewicz, Pol-LA (Polish Laparoscopic Appendectomy) Collaborative Study Group

Videosurgery Miniinv 2019; 14 (1): 70–78
Online publish date: 2018/07/24
View full text
Get citation
JabRef, Mendeley
Papers, Reference Manager, RefWorks, Zotero
According 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.

To identify potential risk factors for intraabdominal abscess after laparoscopic appendectomy (LA).

Material and methods
Eighteen 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.

4618 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).

Intraabdominal 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.


laparoscopic appendectomy, acute appendicitis, complications, intraabdominal abscess, complicated appendicitis

Sauerland S, Jaschinski T, Neugebauer EA. Laparoscopic versus open surgery for suspected appendicitis. Cochrane Database Syst Rev 2010; 10: CD001546.
Semm K. Endoscopic appendectomy. Endoscopy 1983; 15: 59-64.
Donmez T, Sunamak O, Ferahman S, et al. Two-port laparoscopic appendectomy with the help of a needle grasper: better cosmetic results and fewer trocars than conventional laparoscopic appendectomy. Videosurgery Miniinv 2016; 11: 105-10.
Frazee RC, Roberts JW, Symmonds RE, et al. A prospective randomized trial comparing open versus laparoscopic appendectomy. Ann Surg 1994; 219: 725-8.
Guller U, Hervey S, Purves H, et al. Laparoscopic versus open appendectomy: outcomes comparison based on a large administrative database. Ann Surg 2004; 239: 43-52.
Popa D, Soltes M, Uranues S, et al. Are there specific indications for laparoscopic appendectomy? A review and critical appraisal of the literature. J Laparoendosc Adv Surg Tech A 2015; 25: 897-902.
von Elm E, Altman DG, Egger M, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet 2007; 370: 1453-7.
Agresta F, Campanile FC, Podda M, et al. Current status of laparoscopy for acute abdomen in Italy: a critical appraisal of 2012 clinical guidelines from two consecutive nationwide surveys with analysis of 271,323 cases over 5 years. Surg Endosc 2017; 31: 1785-95.
Mandrioli M, Inaba K, Piccinini A, et al. Advances in laparoscopy for acute care surgery and trauma. World J Gastroenterol 2016; 22: 668-80.
Sartelli M, Baiocchi GL, Di Saverio S, et al. Prospective Observational Study on acute Appendicitis Worldwide (POSAW). World J Emerg Surg 2018; 13: 19.
Sauerland S, Lefering R, Neugebauer EA. Laparoscopic versus open surgery for suspected appendicitis. Cochrane Database Syst Rev 2002; 1: CD001546.
Sauerland S, Lefering R, Neugebauer EA. Laparoscopic versus open surgery for suspected appendicitis. Cochrane Database Syst Rev 2004; 4: CD001546.
Ukai T, Shikata S, Takeda H, et al. Evidence of surgical outcomes fluctuates over time: results from a cumulative meta-analysis of laparoscopic versus open appendectomy for acute appendicitis. BMC Gastroenterol 2016; 16: 37.
Liu Z, Zhang P, Ma Y, et al. Laparoscopy or not: a meta-analysis of the surgical effects of laparoscopic versus open appendicectomy. Surg Laparosc Endosc Percutan Tech 2010; 20: 362-70.
Ohtani H, Tamamori Y, Arimoto Y, et al. Meta-analysis of the results of randomized controlled trials that compared laparoscopic and open surgery for acute appendicitis. J Gastrointest Surg 2012; 16: 1929-39.
Li X, Zhang J, Sang L, et al. Laparoscopic versus conventional appendectomy: a meta-analysis of randomized controlled trials. BMC Gastroenterol 2010; 10: 129.
Ingraham AM, Cohen ME, Bilimoria KY, et al. Comparison of outcomes after laparoscopic versus open appendectomy for acute appendicitis at 222 ACS NSQIP hospitals. Surgery 2010; 148: 625-35.
Schlottmann F, Sadava EE, Peña ME, Rotholtz NA. Laparoscopic appendectomy: risk factors for postoperative intraabdominal abscess. World J Surg 2017; 41: 1254-8.
Cho J, Park I, Lee D, et al. Risk factors for postoperative intra-abdominal abscess after laparoscopic appendectomy: analysis for consecutive 1,817 experiences. Dig Surg 2015; 32: 375-81.
Schlottmann F, Sadava EE, Pena ME, Rotholtz NA. Laparoscopic appendectomy: risk factors for postoperative intraabdominal abscess. World J Surg 2017; 41: 1254-8.
Petrowsky H, Demartines N, Rousson V, Clavien PA. Evidence-based value of prophylactic drainage in gastrointestinal surgery: a systematic review and meta-analyses. Ann Surg 2004; 240: 1074-84.
Allemann P, Probst H, Demartines N, Schafer M. Prevention of infectious complications after laparoscopic appendectomy for complicated acute appendicitis: the role of routine abdominal drainage. Langenbecks Arch Surg 2011; 396: 63-8.
Cheng Y, Zhou S, Zhou R, et al. Abdominal drainage to prevent intra-peritoneal abscess after open appendectomy for complicated appendicitis. Cochrane Database Syst Rev 2015; 2: CD010168.
Bae E, Dehal A, Franz V, et al. Postoperative antibiotic use and the incidence of intra-abdominal abscess in the setting of suppurative appendicitis: a retrospective analysis. Am J Surg 2016; 212: 1121-5.
Kimbrell AR, Novosel TJ, Collins JN, et al. Do postoperative antibiotics prevent abscess formation in complicated appendicitis? Am Surg 2014; 80: 878-83.
van Rossem CC, Schreinemacher MH, Treskes K, et al. Duration of antibiotic treatment after appendicectomy for acute complicated appendicitis. Br J Surg 2014; 101: 715-9.
Quick links
© 2019 Termedia Sp. z o.o. All rights reserved.
Developed by Bentus.
PayU - płatności internetowe