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Re-laparoscopy for the treatment of complications after laparoscopic appendectomy: is it possible to maintain the minimally invasive approach?

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Abstract

Despite laparoscopy is considered an adequate tool for the diagnosis and management of postoperative surgical complications, its role after laparoscopic appendectomy (LA) remains uncertain. The aim of this study was to evaluate whether laparoscopy is useful for treating complications after laparoscopic appendectomy. A retrospective analysis of a prospectively collected database of patients undergoing LA, who needed a reoperation for postoperative complications during the period 2006–2020, was performed. Demographics, operative variables, and postoperative outcomes were analyzed. A total of 2019 LA were performed, and 41 patients (2%) underwent a RL for post appendectomy complications. Twenty-three patients (56%) were male. The mean age was 32 years old (16–92 years). The majority of patients (75%) had a complicated acute appendicitis in the first operation. The most common findings at RL were generalized peritonitis (36.4%) and intraabdominal abscesses (26.8%). Five patients (12.1%) developed stump appendicitis, all of them as a late complication. The procedures were completed laparoscopically in 85% and 6 patients (15%) required conversion to an open approach. Three patients (7.3%) required a percutaneous drainage and two patients (4.9%) needed an additional surgery (laparotomy) after RL, all of them presenting with generalized peritonitis at the RL. No mortality was registered. Re-laparoscopy is feasible, safe, and highly effective for the diagnosis and treatment of post appendectomy complications. RL should be encouraged to avoid more aggressive procedures.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author upon reasonable request.

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Authors and Affiliations

  1. Department of Surgery, Hospital Alemán of Buenos Aires, University of Buenos Aires, Av. Pueyrredón 1640 (ATT 1118), Buenos Aires, Argentina

    María A. Casas, Francisco Laxague, Francisco Schlottmann & Emmanuel Ezequiel Sadava

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  1. María A. Casas
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  2. Francisco Laxague
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  3. Francisco Schlottmann
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  4. Emmanuel Ezequiel Sadava
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by MAC, FL, FS and EES. The first draft of the manuscript was written by MAC and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Emmanuel Ezequiel Sadava.

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The ethics committee and review board of our institution approved the study and treatment protocol.

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Casas, M.A., Laxague, F., Schlottmann, F. et al. Re-laparoscopy for the treatment of complications after laparoscopic appendectomy: is it possible to maintain the minimally invasive approach?. Updates Surg 73, 2199–2204 (2021). https://doi.org/10.1007/s13304-020-00917-0

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  • DOI: https://doi.org/10.1007/s13304-020-00917-0

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