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Irrigation versus suction alone during laparoscopic appendectomy for perforated appendicitis: a prospective randomized trial.

Publication ,  Journal Article
St Peter, SD; Adibe, OO; Iqbal, CW; Fike, FB; Sharp, SW; Juang, D; Lanning, D; Murphy, JP; Andrews, WS; Sharp, RJ; Snyder, CL; Holcomb, GW; Ostlie, DJ
Published in: Ann Surg
October 2012

BACKGROUND: The efficacy of irrigating the peritoneal cavity during appendectomy for perforated appendicitis has been debated extensively. To date, prospective comparative data are lacking. Therefore, we conducted a prospective, randomized trial comparing peritoneal irrigation to suction alone during laparoscopic appendectomy in children. METHODS: Children younger than 18 years with perforated appendicitis were randomized to peritoneal irrigation with a minimum of 500 mL normal saline, or suction only during laparoscopic appendectomy. Perforation was defined as a hole in the appendix or fecalith in the abdomen. The primary outcome variable was postoperative abscess. Using a power of 0.8 and alpha of 0.05, a sample size of 220 patients was calculated. A battery-powered laparoscopic suction/irrigator was used in all cases. Pre- and postoperative management was controlled. Data were analyzed on an intention-to-treat basis. RESULTS: A total of 220 patients were enrolled between December 2008 and July 2011. There were no differences in patient characteristics at presentation. There was no difference in abscess rate, which was 19.1% with suction only and 18.3% with irrigation (P = 1.0). Duration of hospitalization was 5.5 ± 3.0 with suction only and 5.4 ± 2.7 days with group (P = 0.93). Mean hospital charges was $48.1K in both groups (P = 0.97). Mean operative time was 38.7 ± 14.9 minutes with suction only and 42.8 ± 16.7 minutes with irrigation (P = 0.056). Irrigation was felt to be necessary in one case (0.9%) randomized to suction only. In the patients who developed an abscess, there was no difference in duration of hospitalization, days of intravenous antibiotics, duration of home health care, or abscess-related charges. CONCLUSIONS: There is no advantage to irrigation of the peritoneal cavity over suction alone during laparoscopic appendectomy for perforated appendicitis. The study was registered with clinicaltrials.gov at the inception of enrollment (NCT00981136).

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Published In

Ann Surg

DOI

EISSN

1528-1140

Publication Date

October 2012

Volume

256

Issue

4

Start / End Page

581 / 585

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Surgery
  • Suction
  • Prospective Studies
  • Postoperative Complications
  • Peritoneal Lavage
  • Male
  • Laparoscopy
  • Intention to Treat Analysis
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
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St Peter, S. D., Adibe, O. O., Iqbal, C. W., Fike, F. B., Sharp, S. W., Juang, D., … Ostlie, D. J. (2012). Irrigation versus suction alone during laparoscopic appendectomy for perforated appendicitis: a prospective randomized trial. Ann Surg, 256(4), 581–585. https://doi.org/10.1097/SLA.0b013e31826a91e5
St Peter, Shawn D., Obinna O. Adibe, Corey W. Iqbal, Frankie B. Fike, Susan W. Sharp, David Juang, David Lanning, et al. “Irrigation versus suction alone during laparoscopic appendectomy for perforated appendicitis: a prospective randomized trial.Ann Surg 256, no. 4 (October 2012): 581–85. https://doi.org/10.1097/SLA.0b013e31826a91e5.
St Peter SD, Adibe OO, Iqbal CW, Fike FB, Sharp SW, Juang D, et al. Irrigation versus suction alone during laparoscopic appendectomy for perforated appendicitis: a prospective randomized trial. Ann Surg. 2012 Oct;256(4):581–5.
St Peter, Shawn D., et al. “Irrigation versus suction alone during laparoscopic appendectomy for perforated appendicitis: a prospective randomized trial.Ann Surg, vol. 256, no. 4, Oct. 2012, pp. 581–85. Pubmed, doi:10.1097/SLA.0b013e31826a91e5.
St Peter SD, Adibe OO, Iqbal CW, Fike FB, Sharp SW, Juang D, Lanning D, Murphy JP, Andrews WS, Sharp RJ, Snyder CL, Holcomb GW, Ostlie DJ. Irrigation versus suction alone during laparoscopic appendectomy for perforated appendicitis: a prospective randomized trial. Ann Surg. 2012 Oct;256(4):581–585.

Published In

Ann Surg

DOI

EISSN

1528-1140

Publication Date

October 2012

Volume

256

Issue

4

Start / End Page

581 / 585

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Surgery
  • Suction
  • Prospective Studies
  • Postoperative Complications
  • Peritoneal Lavage
  • Male
  • Laparoscopy
  • Intention to Treat Analysis
  • Humans