[Unplanned redo surgeries after appendectomy characterizing the quality of acute appendicitis management].

Abstract

Objective: To study the effect of appendectomy technique on the incidence, causes and features of redo surgeries after appendectomy.

Material and methods: Appendectomies were performed in 1114 patients. Repeated interventions were necessary in 19 (1.4%) people (10 (2.0%) patients after laparoscopic appendectomy and 9 (1.5%) patients after open surgery). Structure, surgical features and results are estimated.

Results: There were 505 (45.3%) laparoscopic and 609 (54.7%) open appendectomies. Repeated interventions were performed in 10 (0.9%) and 9 (1.5%) cases, respectively. The causes of repeated surgeries were abdominal infectious complications in 7 (0.6%) cases, intra-abdominal bleeding in 5 people (0.4%), abdominal wall infection in 3 (0.3%) cases, eventeration in 4 (0.35%) cases, undiagnosed intestinal obstruction during index surgery in 1 patient (0.1%) and severe abdominal pain in 1 patient (0.1%). There were complications Clavien-Dindo grade IIIA-IIIB. There were no fatal outcomes. In 2023-2024, 286 laparoscopic appendectomies were performed including 2 (0.69%) repeated interventions. The number of laparoscopic interventions throughout this period exceeded the number of open appendectomies by 2.4 times and amounted to 81.7% of all appendectomies. Repeated interventions after traditional appendectomy were performed in 2 patients (3.1%).

Conclusion: Predominant laparoscopic appendectomies in recent years improved the quality of care for patients with acute appendicitis regarding redo surgeries. Acceptable incidence of repeated interventions indicates sufficient institutional experience in the treatment of acute appendicitis.