Abstract：
BACKGROUND: Laparoscopic appendectomy followed by postoperative intravenous (IV) antibiotics is the standard of care for acute appendicitis and postoperative prevention of intra-abdominal abscesses. The aim of or study was to determine if intraperitoneal irrigation with antibiotics could help prevent intra-abdominal abscess formation after laparoscopic appendectomy for complicated appendicitis in pediatric patients.
METHODS: A retrospective study was conducted on consecutive pediatric patients with acute appendicitis who had appendectomy in our Pediatric Surgery Department between August 2020 and February 2022. We compared two groups with similar age and symptoms. The first group (A) was treated with the normal standard of care, i.e., laparoscopic appendectomy and postoperative IV antibiotic therapy. For the second group (B) intraperitoneal cefazoline irrigation was added at the end of the laparoscopic procedure. Postoperative intra-abdominal abscess was diagnosed with ultrasound examination, performed after clinical suspicion/abnormal blood test results.
RESULTS: One hundred sixty patients (males:females 109:51; median age 10.5 years [range 3-17 years]) who had laparosopic appendectomy for complicated appendicitis were included, 82 in group A and 78 in group B. In the first 7 days after surgery, 18 patients in group and 5 in group B developed an intra-abdominal abscess (p < 0.005). Drains were positioned in 38 patients in group A vs. 9 in group B. One patient in group A had a different complication which was infection of the surgical incision.
CONCLUSIONS: Intraperitoneal cefazoline irrigation at the end of the laparoscopic appendectomy in pediatric patients significantly reduces the formation of intra-abdominal abscesses.
METHODS: A retrospective study was conducted on consecutive pediatric patients with acute appendicitis who had appendectomy in our Pediatric Surgery Department between August 2020 and February 2022. We compared two groups with similar age and symptoms. The first group (A) was treated with the normal standard of care, i.e., laparoscopic appendectomy and postoperative IV antibiotic therapy. For the second group (B) intraperitoneal cefazoline irrigation was added at the end of the laparoscopic procedure. Postoperative intra-abdominal abscess was diagnosed with ultrasound examination, performed after clinical suspicion/abnormal blood test results.
RESULTS: One hundred sixty patients (males:females 109:51; median age 10.5 years [range 3-17 years]) who had laparosopic appendectomy for complicated appendicitis were included, 82 in group A and 78 in group B. In the first 7 days after surgery, 18 patients in group and 5 in group B developed an intra-abdominal abscess (p < 0.005). Drains were positioned in 38 patients in group A vs. 9 in group B. One patient in group A had a different complication which was infection of the surgical incision.
CONCLUSIONS: Intraperitoneal cefazoline irrigation at the end of the laparoscopic appendectomy in pediatric patients significantly reduces the formation of intra-abdominal abscesses.
摘要：
背景：腹腔镜阑尾切除术后静脉（IV）抗生素是急性阑尾炎和术后预防腹腔脓肿的标准治疗方法。研究的目的是确定腹膜内冲洗抗生素是否有助于预防小儿复杂性阑尾炎腹腔镜阑尾切除术后腹腔脓肿的形成。
方法：对2020年8月至2022年2月在我们的小儿外科接受阑尾切除术的连续小儿急性阑尾炎患者进行了回顾性研究。我们比较了年龄和症状相似的两组。第一组(A)采用正常护理标准,即，腹腔镜阑尾切除术和术后静脉抗生素治疗。对于第二组(B),在腹腔镜手术结束时加入头孢唑啉腹膜内冲洗。术后经超声检查诊断为腹内脓肿，在临床怀疑/血液检查结果异常后进行。
结果：纳入了因复杂性阑尾炎进行腹腔镜阑尾切除术的一百六十例患者（男性：女性109:51；中位年龄10.5岁[范围3-17岁]），A组82例,B组78例,手术后第7天,组18例，B组5例发生腹内脓肿（p<0.005）。A组38例患者的引流位置与B组9例，A组1例患者有不同的并发症，为手术切口感染。
结论：小儿腹腔镜阑尾切除术结束时头孢唑啉腹腔冲洗可显著减少腹腔脓肿的形成。
方法：对2020年8月至2022年2月在我们的小儿外科接受阑尾切除术的连续小儿急性阑尾炎患者进行了回顾性研究。我们比较了年龄和症状相似的两组。第一组(A)采用正常护理标准,即，腹腔镜阑尾切除术和术后静脉抗生素治疗。对于第二组(B),在腹腔镜手术结束时加入头孢唑啉腹膜内冲洗。术后经超声检查诊断为腹内脓肿，在临床怀疑/血液检查结果异常后进行。
结果：纳入了因复杂性阑尾炎进行腹腔镜阑尾切除术的一百六十例患者（男性：女性109:51；中位年龄10.5岁[范围3-17岁]），A组82例,B组78例,手术后第7天,组18例，B组5例发生腹内脓肿（p<0.005）。A组38例患者的引流位置与B组9例，A组1例患者有不同的并发症，为手术切口感染。
结论：小儿腹腔镜阑尾切除术结束时头孢唑啉腹腔冲洗可显著减少腹腔脓肿的形成。
