Predictors of Failed Laparoscopic Appendectomy in Perforated Appendicitis
Journal of Acute Care Surgery
;
(2): 59-64, 2018.
Article
in English
| WPRIM
| ID: wpr-717779
ABSTRACT
PURPOSE:
A recent internal review of a community-based hospital system revealed a 19.19% rate of conversion from a laparoscopic appendectomy to an open procedure. This study examined the preoperative risk factors for failed laparoscopic appendectomy requiring a conversion to a laparotomy.METHODS:
A total of 198 patients presented with perforated appendicitis. Perforation was defined as a computed tomography (CT) scan interpretation, pathology findings, or surgical findings. Of these patients, 161 underwent a laparoscopic appendectomy or laparoscopy converted to an open procedure. The preoperative risk factors in the two groups were compared through a retrospective chart review.RESULTS:
Through multivariant analysis, age greater than 45 was the greatest risk factor for the need to convert to an open procedure with an odds ratio (OR) of 3.51. A CT scan read of perforation was associated with a significant 2.65 OR. The C-reactive protein was 19.82 mg/L in the failed laparoscopic cases and 9.96 mg/L in the laparoscopic cases.CONCLUSION:
Patients older than 45 years old with a CT radiologist's read of a perforation in multivariant analysis have an increased risk of failed laparoscopic surgery requiring conversion to open surgery.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Pathology
/
Appendectomy
/
Appendicitis
/
C-Reactive Protein
/
Tomography, X-Ray Computed
/
Odds Ratio
/
Retrospective Studies
/
Risk Factors
/
Laparoscopy
/
Conversion to Open Surgery
Type of study:
Etiology study
/
Observational study
/
Prognostic study
/
Risk factors
Limits:
Humans
Language:
English
Journal:
Journal of Acute Care Surgery
Year:
2018
Type:
Article
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