J Minim Invasive Surg.  2014 Sep;17(3):37-43. 10.7602/jmis.2014.17.3.37.

Advantages of Interval Laparoscopic Appendectomy for Periappendiceal Abscess

• Kim GY
• You SH
• Kye BH
• Kwon TS
• Lee YS
• Oh ST
• Kim JG
• Lee IK

• KMID: 1939531
• DOI: http://doi.org/10.7602/jmis.2014.17.3.37

Abstract

PURPOSE
Laparoscopic appendectomy is a common procedure for treatment of appendicitis. However, in some complicated cases, like periappendiceal abscess, deciding on treatment options is very challenging. Early appendectomy or interval appendectomy may be possible, but remains controversial.
METHODS
We prospectively studied the advantages of interval appendectomy in 21 patients with periappendiceal abscess using a laparoscopic method versus 14 patients with immediate initial laparotomy.
RESULTS
In the interval appendectomy group (INT group), in periappendiceal abscess, use of a laparoscopic method was advantageous in terms of operation time (p<0.001), less fasting time (p<0.001), and fewer postoperative complications (p=0.032). However, the total cost in the INT group was 1,686,000+/-940,000 South Korean won (KRW) compared with 1,506,000+/-322,000 KRW in the early appendectomy group (EAR group) (p=0.007) because patients in the INT group required two hospital visits. The total length of hospital stay postoperatively, was 7.31+/-2.726 days in the INT group, compared with 9.21+/-3.378 days in the EAR group (p=0.537).
CONCLUSION
We recommend interval appendectomy as the preferable approach for the periappendiceal abscess, as it can result in more favorable postoperative surgical outcomes, fewer complications, and less antibiotic usage.

Keyword

Interval appendectomy; Laparoscopic appendectomy; Periappendiceal abscess; Percutaneous drainage; Cost effectiveness

MeSH Terms

Abscess*
Appendectomy*
Appendicitis
Cost-Benefit Analysis
Ear
Fasting
Humans
Laparotomy
Length of Stay
Postoperative Complications
Prospective Studies