Page 125 - Postoperative Intra-Abdominal Adhesions- New insights in prevention and consequences

Table 1. Baseline characteristics. P-value concerns differences between responders and non- responders.
Long-term follow-up after appendectomy
Baseline characteristics
Age at operation
Age ≤ 18 year at operation
Mean follow-up years (SD)
Female
Laparoscopically operated
Perforated appendix
Intra-abdominal abscess
Normal appendix
Wound infection
Conversions
Peroperatively scored adhesions
Hospital stay > 4 days
Total study population n=1481(%)
32,0 405 (27) 7,1 (2.0) 674 (46) 922 (62) 272 (18) 105 (7) 79 (5) 54 (4) 133
175 (12)
482 (33)
Non-responders n=955 (%)
30,1 290 (30) 7,2 (1.9) 404 (42) 560 (59) 157 (16) 59 (6) 51 (5) 39 (4) 81
122 (13)
302 (31)
Responders n=526 (%)
35,5 115 (22) 6,9 (2.0) 270 (51) 362 (69) 115 (22) 46 (9) 28 (5) 15 (3) 52
53 (10)
180 (35)
p-value
<0.001 <0.001 0.017 0.001 <0.001 0.012 0.082 1.000 0.287 0.97 0.124
0.276
Within 3 years after appendectomy for perforated appendecitis 8 out of
115 (7%) responders visited the outpatient clinic or were readmitted
to the hospital because of possibly adhesion-related nonspecific abdominal pain, all treated conservatively (non-perforated 6 out of 411
patients (2%) p=0.003). Three patients without history of perforation 7 or abscess formation were operated on SBO; two of these patients underwent additional abdominal surgery (one liver transplantation and
one incisional hernia operation) in the years between appendectomy and the operation for SBO.
Analysis of complicated versus non-complicated appendicitis in the responder group did not reveal any significant differences in abdominal complaints in the last 6 months between both groups (table 3). Additionally no significant differences were seen between OA or LA and adhesions scored at initial operation did not result in significantly more abdominal complaints as well. Furthermore, analysis of all 159 patients with abdominal complaints who completed the GIQLI-questionnaire did not demonstrate significant differences in the digestion subscale for gender, operation technique, abdominal abscesses, drain placement, perforation or per-operative scored adhesions (Table 4).
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