Is Laparoscopic Incidental Appendectomy in Gynecological Diseases Related to Postoperative Intraabdominal Infection and Complications?

Objective: To establish whether laparoscopic incidental appendectomy in gynecological diseases is related to postoperative intraabdominal infection and complications.

Study Design: This study was performed prospectively in 443 patients who underwent laparoscopic surgery without appendectomy (n = 222) or with appendectomy (n = 221). On postoperative day 1, drain fluid was cultured in all patients. All data were compared using Student's t test and χ2 test.

Results: Bacteria grew in cultures of 93 patients (21.0%): 38 (17.1%) in the nonappendectomy group and 55 (24.9%) in the appendectomy group (p < 0.01). There were statistical differences in the incidence of bacterial growth, postoperative complications, and post-operative laboratory changes for percentage of neutrophils (p < 0.01) and C-reactive protein (p < 0.01). Thirteen genera of bacteria grew in the drain culture. The 9 commensal organisms of the human intestine were identified in all patients, each 8 genera of bacteria in both groups. The surgical type did not affect the postoperative drain culture results.

Conclusion: Postoperative bacterial growth and complications were increased in the laparoscopic incidental appendectomy group. Infections with bacteria from the intestine in both groups were also related to contamination during surgery and postoperative care.