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Complicated Acute Appendicitis (peritonitis), Laparoscopic Management Comparison of Two Techniques

Gustavo Adolfo Aguirre Bermudez, MD, Andres Ricardo Falla, Md, William Sanchez Maldonado, MD, FACS

CENTRAL MILITARY HOSPITAL BOGOTA COLOMBIA

Objective: To compare the results of laparoscopic management of complicated acute appendicitis in the period from November 1, 2011 to April 30, 2012 to evaluate the efficiency of the drying technique (S) vs. washing and aspirate (LA) in patients with intraoperative diagnosis of peritonitis and the rate of surgical site infection (ISO).

Methods: Descriptive study type factor expo which analyzed patients diagnosed with acute appendicitis who underwent surgery were excluded laparoscopic intraoperative diagnosis of patients with appendiceal pathology or were not capable of medical management.

Two techniques were compared one wash and aspirate (LA) and drying (S).

Statistical analysis was performed using EpiInfo version 7.0 were considered significant values P <0.05.

techinique description: washing and aspirate: cavity lavage with 3000 ml of warm saline 0,9 %, rear suction of peritoneal recesses until clear return; drying: aspirate peritoneal reaction liquid and drying with gauze in peritoneal recesses

Results: We included 57 patients who were 30 women and 27 men, 30 patients with uncomplicated appendicitis phase 52.63%, 27 patients with acute appendicitis complicated phase 47.37%,

Of the group of patients with complicated appendicitis and peritonitis 24 had discriminated according to the management found that 9 patients (37.5%) were managed with cavity lavage and aspiration (LA) and 15 (62.5%) were managed with drying (S) .

Of the patients who were taken to the ISO had 44.4% (p 0.025), while patients who were taken to dry cavity isodeveloping only one (6.67%), none of the patients with uncomplicated appendicitis development phase complications.

Conclusions: Patients diagnosed with peritonitis who were taken to washing and vacuuming the cavity showed increased rates of surgical site infection compared with patients who only performed drying cavity statistically significant results showing 44.4 vs 6.7 % (p 0.025, 95% CI 0.32 to 0.13 RR). showing a higher rate of organ space infection type ls patient were taken to washing and vacuuming (LA) compared with only drying (s)


Session: Poster Presentation

Program Number: P597

391

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