Page 129 - Postoperative Intra-Abdominal Adhesions- New insights in prevention and consequences

Long-term follow-up after appendectomy
no significant difference in the incidence of abdominal complaints was found between the OA or LA. Furthermore, in the group of patients who did indicate abdominal complaints in the last 6 months the digestion subscale score did not result in a significant difference between both techniques. Although a large number of experiments and clinical studies show that, in general, adhesion formation is less pronounced after laparoscopy when compared to open surgery, our data suggest that this difference does not result in more abdominal complaints after OA [21- 24].
In total 526 (37%) patients returned a questionnaire suitable for complete
analysis. Other retrospective quality of life studies reported follow-up percentages between 39 and 52% after 2.5 to 7 years of follow-up with
169-374 total number of patients [20, 25, 26]. Our study group consists
of the population of Rotterdam, a city with 174 different nationalities,
which may have contributed to a lower response as a consequence of
language issues. Regarding this and considering a follow-up of 7 years
we think we have reached an acceptable response rate. Nevertheless
these retrospective data should be interpreted carefully because of 7 selection bias. In the responder group slightly more patients underwent
LA compared to the total study population. This might be explained by the shorter follow-up time in the responder group since in recent years LA became the technique of first choice. Furthermore, females were overrepresented in our responder group (51% (responder) vs 46% (non-responder)). A plausible explanation for this discrepancy might be found in the predomination of females in the response rate of postal questionnaires, which is well defined in literature [27, 28].
In conclusion, our study results enable surgeons to inform their patients about the long-term results of appendectomy, whether it was complicated or not.
Conflict of interest
The authors declare no conflict of interest.
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