UNCOMPLICATED ACUTE APPENDICITIS: WHAT MAKES IT COMPLICATED? sbertona@hospitalaleman.com

PW03-12

UNCOMPLICATED ACUTE APPENDICITIS: WHAT MAKES IT COMPLICATED?

6

Argentina

Oral only

Uncomplicated acute appendicitis (UAA) represents the most common form of acute appendicitis, with a low expected rate of postoperative morbidity. However, in clinical practice, some UAA patients develop major postoperative complications, impacting surgical outcomes. Identifying factors associated with these complications could improve perioperative decision-making and help select candidates for strategies such as early discharge.

We performed a retrospective analysis of a consecutive series of patients who underwent laparoscopic appendectomy for UAA between 2008 and 2024. The sample was divided into two groups: those without postoperative complications (NC) and those with major complications (MC). MC were defined as intra-abdominal abscesses, appendiceal stump dehiscence, hemoperitoneum, or unintentional small bowel injury. Demographic, clinical, surgical, and postoperative variables were analyzed. A multivariable logistic regression analysis was performed to identify independent factors associated with major complications.

Of 2857 laparoscopic appendicectomy, 2101 (73.5%) were for UAA. MC occurred in 51 patients (2.4%). Male sex (66% vs 51.3%, p=0.04) and obesity (BMI >30 22.2% vs 6.3%, p<0.0001) were more frequent in the MC group. Night-time surgeries were also more common (43% vs 23.5%, p=0.002). No significant differences were found in operative time, trainee involvement, length of stay, early discharge, or antibiotic use. In multivariate analysis, obesity was the only independent predictor of MC (OR 11.47, 95% CI 2.08–63.34, p=0.005).

Although uncommon, major complications can occur following UAA. Obesity is an independent risk factor and may justify enhanced postoperative surveillance.