Wound infection after emergency appendectomy by open vs laparoscopic approach: a multicenter retrospective large cohort study

Abstract

Objective Emergency laparoscopic appendectomy (LA) has been rapidly applied at county-level hospitals in China.This study is to analyze wound infection after appendectomy.Methods This retrospective study was conducted among patients with acute appendicitis undergoing either laparoscopic or open appendectomy (OA) at 6 county-level general hospitals in Eastern China from 2011 to 2013,using multivariate Logistic regression model to assess independent risk factors associated with wound infection.Results Among 9 340 patients,1 831 (19.6％) and 7 509 (80.4％) patients underwent LA and OA respectively.The overall postoperative wound infection rate was 5.1％.The proportion of LAs increased yearly from 9.2％ to 15.0％ to 32.9％,while the LA postoperative wound infection rate decreased from 5.6％ to 4.4％ to 3.5％ (P ＜ 0.05).Compared with OA,LA was associated with lower wound infection rate after appendectomy (2.1％ vs.5.8％,P ＜ 0.01).By multivariate logistic regression analysis,various procedure was found to be independently associated with postoperative wound infection [odds ratio (95％ confidence interval) OR (95％ CI),1.37 (1.12-1.63); P =0.02].Conclusions Laparoscopic appendectomy carries a decreasing postoperative wound infection rate by year basis.Laparoscopic procedure was independently associated with a significantly lower incidence of wound infection after appendectomy. Key words: Appendectomy ; Postoperative complications ; Infection ; Laparoscopes