Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Oct-Dec;19(4):241-244.
doi: 10.4103/ajps.ajps_146_21.

Peritoneal lavage during laparoscopic appendectomy for complex appendicitis is associated with increased post-operative morbidity

Darren Puttock  1 , Vikrant Kumbhar  1 , Haitham Dagash  1 , Nitin Patwardhan  1
Affiliations

Peritoneal lavage during laparoscopic appendectomy for complex appendicitis is associated with increased post-operative morbidity

Darren Puttock et al. Afr J Paediatr Surg. 2022 Oct-Dec.

Abstract

Aim: Appendicitis is one of the most common paediatric surgical pathologies seen by paediatric surgeons worldwide. Laparoscopic appendectomy is undertaken for all cases of appendicitis in our institute. Intraperitoneal lavage following appendectomy is the conventional way of managing complicated appendicitis; however, some surgeons debate the efficacy of this practice. The aim of this study was to compare outcomes of intraperitoneal lavage versus suction only in children with complicated appendicitis.

Methods: Data were collected retrospectively between January 2018 and January 2019. All patients undergoing laparoscopic appendectomy for complex appendicitis were included and divided into two groups, patients who had suction only and those who had lavage and suction. Outcome parameters studied were the length of stay (LOS), number of temperature spikes > 37.7 (TS), operative times (OT) and readmission for intra-abdominal collections. Comparison between the two groups was performed using two sample t-test with unequal variance, significance was set at P < 0.05.

Results: A total of 115 patients were included (lavage n = 52, Suction n = 63). The LOS (P = 0.0054), TS (0.0109), OT (P < 0.0001) were significantly higher in the lavage group compared to the suction-only group. Overall rates of readmission were similar between groups, however, readmission for the confirmed intra-abdominal collection was more common in the lavage group.

Conclusion: Based on our study, it appears that there is no advantage in performing an intraperitoneal lavage for complex appendicitis. It resulted in a prolonged stay, more post-operative TS and longer operative duration. The likelihood of being readmitted with an intra-abdominal collection following a lavage was higher compared to suction only.

Keywords: Complex appendicitis; intra-abdominal collection; laparoscopic appendicectomy; length of stay; peritoneal lavage; temperature spikes.

PubMed Disclaimer

Conflict of interest statement

None

Similar articles

See all similar articles

Cited by

  • The burden of the knowledge-to-action gap in acute appendicitis.
    Cioffi SPB, Altomare M, Podda M, Spota A, Granieri S, Reitano E, Zamburlini B, Virdis F, Bini R, Gupta S, Torzilli G, Mingoli A, Chiara O, Cimbanassi S; REsiDENT-1 research group. Cioffi SPB, et al. Surg Endosc. 2023 Dec;37(12):9617-9632. doi: 10.1007/s00464-023-10449-4. Epub 2023 Oct 26. Surg Endosc. 2023. PMID: 37884735 Free PMC article.

References

    1. Bhangu A, Søreide K, Di Saverio S, Assarsson JH, Drake FT. Acute appendicitis: Modern understanding of pathogenesis, diagnosis, and management. Lancet. 2015;386:1278–87. - PubMed
    1. Savoie KB, Shelby RD, Dykes MW, Diefenbach KA, Besner GE, Kenney BD. Volume of irrigation does not affect rate of abscess in perforated appendicitis. J Laparoendosc Adv Surg Tech A. 2019;29:1232–8. - PubMed
    1. Sun F, Wang H, Zhang F, Zhang X, Xing Z, Zhang S, et al. Copious irrigation versus suction alone during laparoscopic appendectomy for complicated appendicitis in adults. J Invest Surg. 2018;31:342–6. - PubMed
    1. Hotchkiss LW. V. The treatment of diffuse suppurative peritonitis, following appendicitis. Ann Surg. 1906;44:197–208. - PMC - PubMed
    1. Hartwich JE, Carter RF, Wolfe L, Goretsky M, Heath K, St Peter SD, et al. The effects of irrigation on outcomes in cases of perforated appendicitis in children. J Surg Res. 2013;180:222–5. - PubMed