• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • COVID-19 Annoucements
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Advocacy
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
  • Meetings
    • NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2023 Scientific Session Call For Abstracts
      • 2023 Emerging Technology Call For Abstracts
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Past Meetings
      • SAGES 2022
      • SAGES 2021
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Video Based Assessments (VBA)
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • NEW-Area of Concentrated Training Seal (ACT)-Advanced Flexible Endoscopy-Coming Soon!
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Multi-Society Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • Store
    • “Unofficial” Logo Products
  • Log In

Appendiceal Phlegmon; A Laparoscopically Defeated Foe

Hani H Haider, MD, Dalal F Al-aradi, MD, Ramla T Juma, MD, Waleed Al-herz, MD, Talib Juma, MD. Department of Surgery, Amiri Hospital, Kuwait.

 

INTRODUCTION: It is not clearly documented in the literature whether laparoscopic appendectomy for phlegmons is destined to a high rate of conversion to open surgery or not. The aim of this study is to concentrate on the rate of conversion, and the factors that contributes to it.

 

METHODS AND PROCEDURES: A retrospective analysis of a prospectively collected data in a major governmental hospital from year 2000 till April 2011. We identified 125 cases of appendiceal masses out of 2358 laparoscopic appendectomies performed during the study period (5%). One patient was excluded from the study because of concurrent pregnancy. Statistical analysis used included Pearson’s chi-square and student’s t-test.

 

RESULTS: There were 76 males (61%) and 48 females (39%) in our study patients with an average age of 34 years (9-78 years). Twenty three percent of the patients had pre-existing medical comorbidities. Average onset of pain at presentation was 2.3 days (1-10 days), while surgery was performed on an average 2.7 days (1-11 days) from onset of pain. In 10% of the cases a mass was identified on imaging studies (US or CT), while it was negative in 42%, and the remaining patients (48%) were not imaged before surgery. A mass was felt in only 5% of the cases on physical exam. When onset of pain was 3 days or more, senior surgeons were involved more in the surgery than junior surgeons (65% versus 28%, P=0.001). Average surgery time was 72 minutes (20-150 min.). 19 patients needed conversion out of 124 (15%), (14 difficult dissection, 4 bleeding, and 1 due to injury to ileum). Conversion was highest when onset of pain was 3 days or more (32% versus 5%, P=0.001). Conversion to midline incision was in 21%, and the remaining through incision at McBurney’s point. Post-operative complications developed in 8% of patients after laparoscopy and 29% after open surgery (P=0.02), and developed more in patients with pre-existing medical comorbidities (28% versus 6%, P=0.003) (Ileus 42%, Pneumonia 25%, myocardial infarction 8%, pulmonary embolism 8%, Wound infection 8%, pelvic abscess 8%, and no case of surgical site infection, leak, or post-operative bleeding). Post-op diet was started later when patients developed post-operative complications (4 days versus 2 days P=0.00). Average hospital stay after laparoscopy was 4 days while that after open 6 days (P=0.02).

 

CONCLUSIONS: Laparoscopic appendectomy can be successfully performed in 85% of the cases of appendiceal phlegmons. There was a higher chance of conversion to open when onset of pain was 3 days or more. Laparoscopy significantly decreased post-operative complications and hospital stay. The reason for the low conversion rate in our study could be attributed to the more involvement of senior surgeons in this kind of cases.


Session Number: Poster – Poster Presentations
Program Number: P097
View Poster

1,566

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

« Return to SAGES 2012 abstract archive

Our Mission

Innovate, educate and collaborate to improve patient care.

Recently, on SAGES…

Critical View of Safety (CVS) Challenge QR Code

The SAGES Critical View of Safety Challenge – Donate Your Lap Chole Videos!

The Society of American Gastrointestinal and Endoscopic Surgeons is hosting the first Artificial Intelligence Data Challenge conducted by surgeons. The aim of this challenge is to generate a large and diverse dataset of laparoscopic cholecystectomy videos, annotated with respect to the subcomponents of the Critical View of Safety (CVS). Computer scientists from all over the […]

Respuesta de SAGES al Estudio NordICC sobre el beneficio de las colonoscopias de detección

SAGES desea aclarar los resultados del estudio NordICC y colocarlos en contexto de los esfuerzos de varias agencias nacionales para reducir el riesgo de cáncer colorrectal – la segunda causa de muerte por cáncer más frecuente en los Estados Unidos-, mediante la promoción de la detección y tratamiento oportuno de las lesiones.

SAGES Response to NordICC Study Regarding Benefit of Screening Colonoscopies

The NordICC Study recently published in The New England Journal of Medicine and widely reported on by media outlets has raised questions regarding the benefit of screening colonoscopy in lowering the risk of colorectal cancer and cancer-related deaths among otherwise healthy and symptom-free men and women aged 55 to 64. Provocative headlines and commentaries have […]

Contact SAGES

Society of American Gastrointestinal and Endoscopic Surgeons
11300 W. Olympic Blvd Suite 600
Los Angeles, CA 90064 USA
webmaster@sages.org
Tel: (310) 437-0544

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Important Links

SAGES 2023 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2023 Society of American Gastrointestinal and Endoscopic Surgeons