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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.
Subject(s)

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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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