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Re-laparoscopy for the treatment of complications after laparoscopic appendectomy: is it possible to maintain the minimally invasive approach?
Casas, María A; Laxague, Francisco; Schlottmann, Francisco; Sadava, Emmanuel Ezequiel.
Afiliação
  • Casas MA; Department of Surgery, Hospital Alemán of Buenos Aires, University of Buenos Aires, Av. Pueyrredón 1640 (ATT 1118), Buenos Aires, Argentina.
  • Laxague F; Department of Surgery, Hospital Alemán of Buenos Aires, University of Buenos Aires, Av. Pueyrredón 1640 (ATT 1118), Buenos Aires, Argentina.
  • Schlottmann F; Department of Surgery, Hospital Alemán of Buenos Aires, University of Buenos Aires, Av. Pueyrredón 1640 (ATT 1118), Buenos Aires, Argentina.
  • Sadava EE; Department of Surgery, Hospital Alemán of Buenos Aires, University of Buenos Aires, Av. Pueyrredón 1640 (ATT 1118), Buenos Aires, Argentina. esadava@hospitalaleman.com.
Updates Surg ; 73(6): 2199-2204, 2021 Dec.
Article em En | MEDLINE | ID: mdl-33174113
Despite laparoscopy is considered an adequate tool for the diagnosis and management of postoperative surgical complications, its role after laparoscopic appendectomy (LA) remains uncertain. The aim of this study was to evaluate whether laparoscopy is useful for treating complications after laparoscopic appendectomy. A retrospective analysis of a prospectively collected database of patients undergoing LA, who needed a reoperation for postoperative complications during the period 2006-2020, was performed. Demographics, operative variables, and postoperative outcomes were analyzed. A total of 2019 LA were performed, and 41 patients (2%) underwent a RL for post appendectomy complications. Twenty-three patients (56%) were male. The mean age was 32 years old (16-92 years). The majority of patients (75%) had a complicated acute appendicitis in the first operation. The most common findings at RL were generalized peritonitis (36.4%) and intraabdominal abscesses (26.8%). Five patients (12.1%) developed stump appendicitis, all of them as a late complication. The procedures were completed laparoscopically in 85% and 6 patients (15%) required conversion to an open approach. Three patients (7.3%) required a percutaneous drainage and two patients (4.9%) needed an additional surgery (laparotomy) after RL, all of them presenting with generalized peritonitis at the RL. No mortality was registered. Re-laparoscopy is feasible, safe, and highly effective for the diagnosis and treatment of post appendectomy complications. RL should be encouraged to avoid more aggressive procedures.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Apendicite / Laparoscopia / Abscesso Abdominal Tipo de estudo: Observational_studies Limite: Adult / Humans / Male Idioma: En Revista: Updates Surg Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Argentina País de publicação: Itália

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Apendicite / Laparoscopia / Abscesso Abdominal Tipo de estudo: Observational_studies Limite: Adult / Humans / Male Idioma: En Revista: Updates Surg Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Argentina País de publicação: Itália