The Effect of Peritoneal Repair or Non-Repair on Complications after open Appendectomy

Appendicitis is the most common condition of emergency surgery. Complications after appendectomy include skin complications, infection, postoperative pain, hernia and obstruction. There is a difference of opinion among surgeons on peritoneal repair after abdominal surgery. Therefore, we aimed here to evaluate the effect of peritoneal repair versus non-repair in appendectomy patients in terms of postoperative complications.

The present clinical trial study that was conducted on 126 patients who underwent open appendectomy at Shahid Beheshti Hospital of Yasuj, Iran, from 2019 to 2020 who had the inclusion criteria. In the present study, randomization was performed systematically. Clinical observations and follow-up of patients was one week, three months and six months after surgery. After collecting and forming the data file in the computer, the information was analyzed using descriptive analytical statistics (including frequency distribution table, analysis of variance, T-test, chi-square) through SPSS software.

Out of 126 candidates for appendectomy, 60 were male and 66 were female. Among them, 64 (50.8%) underwent surgery with peritoneal repair and 62 (49.2%) underwent surgery without peritoneal repair. The mean age of this population was 26.88 13 13.82 years and ranged from 5 to 65 years. The results indicated that in both the peritoneal repair and non-peritoneal repair groups, 62 patients (69.9%) had no infection and 2 patients (3.1%) had purulent drainage, symptoms of infection, and SSI. Moreover, in the group with peritoneal repair, 42 patients (65.6%) had moderate pain, 16 patients (25.0%) had mild pain and 6 patients (9.4%) had moderate pain. In the non-peritoneal repair group, 50 patients (80.6%) had no pain, 11 patients (17.7%) had mild pain and 1 patient (1.6%) had moderate pain. There was no marked difference between the two groups of appendectomy with peritoneal repair and without peritoneal repair, in the presence of infection, hernia and obstruction, as well as pain intensity, but the presence of pain in patients without peritoneal repair was significantly less.

The results of the present study revealed that the appendectomy surgical methods, including open and closed peritoneum, did not indicate a significant difference for wound site infection. On the other hand, the amount of postoperative pain was lower in the open peritoneum group. Therefore, it is suggested to use appendectomy without peritoneal repair in patients with appendicitis.