Page 120 - Postoperative Intra-Abdominal Adhesions- New insights in prevention and consequences
P. 120

                                Chapter 7
 Abstract
Introduction
Abscess formation and perforation are complications of acute appendicitis that lead to localized or generalized peritonitis. The long-term implications of complicated appendectomy remain largely unknown.
Materials and methods
In the present study it was investigated whether patients with complicated appendicitis experienced more abdominal complaints after long-term follow-up when compared to uncomplicated cases. In addition the influence of operation technique (open versus laparoscopic) was studied. A retrospective analysis of 1,481 appendectomies for acute appendicitis was performed in two centers from January 2000 until January 2006. Demographic data, operative reports, intraoperatively adhesions and complications, abdominal pain and satisfaction were monitored. In total 1433 patients were invited to fill out a questionnaire with a median follow-up of 7.1 years. Questionnaires of 526 (37%) patients were suitable for analysis.
Results
Perforation, abdominal abscesses or adhesions at initial operation did not result in more abdominal complaints when compared to appendectomy for uncomplicated acute appendicitis. Additionally, no significant differences in abdominal complaints were seen between laparoscopic and open techniques.
Conclusion
In conclusion, the results of our study show that after follow-up of seven years the incidence of abdominal complaints was not influenced by operative technique or whether acute appendicitis was complicated or not. This finding does not support a causative role for adhesions with regard to chronic abdominal complaints. Our data enables surgeons to inform their patients about the long-term results of appendectomy, whether it was complicated or not.
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