Abstract
Background: Acute appendicitis remains one of the most common surgical emergencies. Prophylactic antibiotics in laparoscopy for acute uncomplicated appendicitis have decreased the surgical site infection rate. However, the role of postoperative antibiotics in these cases remains unclear. The study aimed to compare the outcomes of prophylactic and postoperative antibiotics in laparoscopy for acute uncomplicated appendicitis.
Methods: This is a prospective study of 200 non - perforated appendicitis patients who underwent laparoscopic appendectomy from January 2022 to September 2022. The participants were divided into two groups: 100 patients in Group 1 were given preoperative prophylactic antibiotics, and 100 patients in Group 2 were given postoperative antibiotics. Postoperative complications and duration of hospital stay were compared between two groups.
Results: There were no significant statistical differences between the two groups in age, sex, body mass index, ASA score, and clinical symptoms variables. No significant differences during surgery in the rates of postoperative complications and surgical site infection (3% vs 4%, P = 0,700) were found between groups. The mean duration of postoperative hospital stay for group 1 (2,3 ± 0,9 days) was shorter than for group 2 (3,4 ± 1,0 days), p < 0,05.
Conclusion: Prophylactic antibiotics would be necessary for laparoscopic appendicectomy for uncomplicated appendicitis. Using postoperative antibiotics does not reduce the surgical site infection rate but may prolong hospital stay.
References
Hosseini Khalifani S, Morshedi M, Mohebi HA et al. Is a Single dose of Prophylactic Antibiotics Sufficient in Patients with Acute Non - Complicated Appendicitis?. Hosp Pract Res. 2016;1(3):83-86.
Cervellin G, Mora R, Ticinesi A et al. Epidemiology and outcomes of acute abdominal pain in a large urban Emergency Department: retrospective analysis of 5,340 cases. Ann Transl Med. 2016;4(19):362-362.
Jaschinski T, Mosch C, Eikermann M et al. Laparoscopic versus open appendectomy in patients with suspected appendicitis: a systematic review of meta - analyses of randomised controlled trials. BMC Gastroenterol. 2015;15(1):48.
Yu MC, Feng Y, Wang W et al. Is laparoscopic appendectomy feasible for complicated appendicitis ? A systematic review and meta - analysis. Int J Surg. 2017;40:187-197.
Andersen BR, Kallehave FL, Andersen HK. Antibiotics versus placebo for prevention of postoperative infection after appendicectomy. Cochrane Database Syst Rev. 2005;2009(1):7-13.
Sartelli M, Viale P, Catena F et al. 2013 WSES guidelines for management of intra-abdominal infections. World J Emerg Surg. 2013; 8(1):3.
Daskalakis K, Juhlin C, and Påhlman L. The use of preor postoperative antibiotics in surgery for appendicitis: A systematic review. Scand J Surg. 2014;103(1);14-20.
Hughes MJ, Harrison E, Paterson - Brown S. Postoperative Antibiotics after Appendectomy and Postoperative Abscess Development: A Retrospective Analysis. Surg Infect (Larchmt). 2013;14(1):56-61.
Di Saverio S, Birindelli A, Kelly MD et al. WSES Jerusalem guidelines for diagnosis and treatment of acute appendicitis. World J Emerg Surg. 2016;11(1):34.
Choi SM, Lee SH, Jang JY et al. Is Single Administration of Prophylactic Antibiotics Enough after Laparoscopic Appendectomy for Uncomplicated Appendicitis?. J ACUTE CARE Surg. 2015;5(2):59-63.
Abounozha S, Ibrahim R, Alshehri FM et al. The role of postoperative antibiotics in preventing surgical site infections in uncomplicated appendicitis. Ann Med Surg. 2021;62: 203-206.
Le D, Rusin W, Hill B et al. Postoperative antibiotic use in non - perforated appendicitis. Am J Surg. 2009;198(6):748-752.
Coakley BA, Sussman ES, Wolfson TS et al. Postoperative Antibiotics Correlate with Worse Outcomes after Appendectomy for Non - perforated Appendicitis. J Am Coll Surg. 2011;213(6):778-783.
Hussain MI, Alam MK., Al - Qahatani HH et al. Role of postoperative antibiotics after appendectomy in non - perforated appendicitis. J Coll Physicians Surg Pak. 2012;22(12):756-9.
Ingraham AM, Cohen ME, Bilimoria KY et al. Comparison of outcomes after laparoscopic versus open appendectomy for acute appendicitis at 222 ACS NSQIP hospitals. Surgery. 2010;148(4):625-637.
Bangaru H, Gaiki VV, Reddy MVR. Comparative study of single dose preoperative antibiotics versus both preoperative and postoperative antibiotics in laparoscopic appendicectomy for non - perforated appendicitis. Int Surg J. 2017;4(9):3092.
Fraser JD, Aguayo P, Leys CM et al. A complete course of intravenous antibiotics vs a combination of intravenous and oral antibiotics for perforated appendicitis in children: a prospective, randomized trial. J Pediatr Surg. 2010;45(6):1198-1202.
| Published | 28-12-2024 — Updated on 28-12-2024 | |
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| Issue | No. 90 (2023) | |
| Section | Original article | |
| DOI | 10.38103/jcmhch.90.3 | |
| Keywords | Kháng sinh dự phòng, kháng sinh sau mổ, phẫu thuật nội soi, viêm ruột thừa cấp không biến chứng. Prophylaxis, antibiotic, laparoscopy, acute uncomplicated appendicitis. |
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