Abstract：
BACKGROUND: Perforated appendicitis is associated with postoperative development of intraperitoneal abscess. Intraperitoneal drain placement during appendectomy is thought to reduce the risk of developing postoperative intraperitoneal abscess. The aim of this study was to determine whether intraperitoneal drainage could reduce the incidence of intraperitoneal abscess formation after laparoscopic appendectomy for perforated appendicitis.
METHODS: This is a retrospective study of all patients (aged 7 and above) who were diagnosed with perforated appendicitis and subsequently underwent laparoscopic appendectomy between January 2018 and December 2022 at two government hospitals in the state of Kuwait. Demographic, clinical, and perioperative characteristics were compared between patients who underwent intraoperative intraperitoneal drain placement and those who did not. The primary outcome was the development of postoperative intraperitoneal abscess. Secondary outcomes included overall postoperative complications, superficial surgical site infection (SSI), length of stay (LOS), readmission and postoperative percutaneous drainage.
RESULTS: A total of 511 patients met the inclusion criteria between 2018 and 2022. Of these, 307 (60.1%) underwent intraoperative intraperitoneal drain placement. Patients with and without drains were similar regarding age, sex, and Charlson Comorbidity Index (CCI) (Table 1). The overall rate of postoperative intraperitoneal abscess was 6.1%. Postoperatively, there was no difference in postoperative intraperitoneal abscess formation between patients who underwent intraperitoneal drain placement and those who did not (6.5% vs. 5.4%, p = 0.707). Patients with intraperitoneal drains had a longer LOS (4 [4, 6] vs. 3 [2, 5] days, p < 0.001). There was no difference in the overall complication (18.6% vs. 12.3%, p = 0.065), superficial SSI (2.9% vs. 2.5%, p = 0.791) or readmission rate (4.9% vs. 4.4%, p = 0.835).
CONCLUSIONS: Following laparoscopic appendectomy for perforated appendicitis, intraperitoneal drain placement appears to confer no additional benefit and may prolong hospital stay.
METHODS: This is a retrospective study of all patients (aged 7 and above) who were diagnosed with perforated appendicitis and subsequently underwent laparoscopic appendectomy between January 2018 and December 2022 at two government hospitals in the state of Kuwait. Demographic, clinical, and perioperative characteristics were compared between patients who underwent intraoperative intraperitoneal drain placement and those who did not. The primary outcome was the development of postoperative intraperitoneal abscess. Secondary outcomes included overall postoperative complications, superficial surgical site infection (SSI), length of stay (LOS), readmission and postoperative percutaneous drainage.
RESULTS: A total of 511 patients met the inclusion criteria between 2018 and 2022. Of these, 307 (60.1%) underwent intraoperative intraperitoneal drain placement. Patients with and without drains were similar regarding age, sex, and Charlson Comorbidity Index (CCI) (Table 1). The overall rate of postoperative intraperitoneal abscess was 6.1%. Postoperatively, there was no difference in postoperative intraperitoneal abscess formation between patients who underwent intraperitoneal drain placement and those who did not (6.5% vs. 5.4%, p = 0.707). Patients with intraperitoneal drains had a longer LOS (4 [4, 6] vs. 3 [2, 5] days, p < 0.001). There was no difference in the overall complication (18.6% vs. 12.3%, p = 0.065), superficial SSI (2.9% vs. 2.5%, p = 0.791) or readmission rate (4.9% vs. 4.4%, p = 0.835).
CONCLUSIONS: Following laparoscopic appendectomy for perforated appendicitis, intraperitoneal drain placement appears to confer no additional benefit and may prolong hospital stay.
摘要：
背景：穿孔性阑尾炎与腹膜内脓肿的术后发展有关。阑尾切除术期间放置腹膜内引流被认为可以降低术后发生腹膜内脓肿的风险。这项研究的目的是确定腹膜内引流是否可以减少腹腔镜阑尾切除术治疗穿孔性阑尾炎后腹膜内脓肿形成的发生率。
方法：这是一项回顾性研究，对2018年1月至2022年12月在科威特州两家政府医院诊断为穿孔性阑尾炎并随后接受腹腔镜阑尾切除术的所有患者（7岁及以上）进行研究。人口统计,临床,对术中腹腔引流和未腹腔引流的患者的围手术期特征进行了比较.主要结果是术后腹膜内脓肿的发展。次要结果包括总体术后并发症，浅表手术部位感染（SSI），停留时间(LOS)再入院和术后经皮引流。
结果：在2018年至2022年期间，共有511例患者符合纳入标准。其中,307（60.1%）接受了术中腹腔引流。有和没有引流的患者年龄相似，性别,和Charlson合并症指数(CCI)(表1)。术后腹腔脓肿的总发生率为6.1%。术后,进行腹膜内引流的患者和未进行腹膜内引流的患者在术后腹膜内脓肿形成方面没有差异（6.5％vs.5.4%,p=0.707)。腹膜内引流的患者LOS较长（4[4，6]vs.3[2,5]天,p<0.001)。总体并发症没有差异(18.6%vs.12.3%,p=0.065),表面SSI（2.9%与2.5%,p=0.791）或再入院率（4.9%与4.4%,p=0.835)。
结论：穿孔性阑尾炎腹腔镜阑尾切除术后，腹膜内引流器的放置似乎不会带来额外的益处，并且可能会延长住院时间。
方法：这是一项回顾性研究，对2018年1月至2022年12月在科威特州两家政府医院诊断为穿孔性阑尾炎并随后接受腹腔镜阑尾切除术的所有患者（7岁及以上）进行研究。人口统计,临床,对术中腹腔引流和未腹腔引流的患者的围手术期特征进行了比较.主要结果是术后腹膜内脓肿的发展。次要结果包括总体术后并发症，浅表手术部位感染（SSI），停留时间(LOS)再入院和术后经皮引流。
结果：在2018年至2022年期间，共有511例患者符合纳入标准。其中,307（60.1%）接受了术中腹腔引流。有和没有引流的患者年龄相似，性别,和Charlson合并症指数(CCI)(表1)。术后腹腔脓肿的总发生率为6.1%。术后,进行腹膜内引流的患者和未进行腹膜内引流的患者在术后腹膜内脓肿形成方面没有差异（6.5％vs.5.4%,p=0.707)。腹膜内引流的患者LOS较长（4[4，6]vs.3[2,5]天,p<0.001)。总体并发症没有差异(18.6%vs.12.3%,p=0.065),表面SSI（2.9%与2.5%,p=0.791）或再入院率（4.9%与4.4%,p=0.835)。
结论：穿孔性阑尾炎腹腔镜阑尾切除术后，腹膜内引流器的放置似乎不会带来额外的益处，并且可能会延长住院时间。
