JOURNAL OF THE JAPANESE ASSOCIATION OF RURAL MEDICINE
Online ISSN : 1349-7421
Print ISSN : 0468-2513
ISSN-L : 0468-2513
ORIGINALS
Preoperative Risk Factors for Pneumoperitoneal Conversion in Transumbilical Laparoscopic-Assisted Appendectomy With a Lifting Retractor for Acute Appendicitis
Atsushi SUGAAtsushi SEYAMATakato NAKAJIMAMasaki OKAMOTOKoshiro UEDAMasanori HAYASHITakashi INOUENobuki MATSUNAMITomoaki MORITA
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2024 Volume 73 Issue 1 Pages 21-26

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Abstract
 We use transumbilical laparoscopic-assisted appendectomy (TULAA) with a lifting retractor as the surgical technique of first choice for acute appendicitis. Although this technique provides excellent cosmetic results and contributes to reducing medical costs, it is less advantageous in difficult-to-complete cases that require conversion to pneumoperitoneum or additional ports. We retrospectively reviewed the records of 76 patients who underwent laparoscopic appendectomy between June 2020 and March 2023 (43 in a TULAA group and 33 in a pneumoperitoneal conversion group) to identify preoperative factors associated with pneumoperitoneal conversion. Univariate analysis showed significant differences for preoperative C-reactive protein (CRP) level, age, and body mass index. Logistic regression analysis identified preoperative CRP level and age as significant risk factors for pneumoperitoneal conversion. The pneumoperitoneal conversion rate was 12.5%, 48.2%, and 68% for patients with 0, 1, and 2 preoperative risk factors, respectively, indicating patients with 2 risk factors were more likely to undergo pneumoperitoneal conversion. These data may inform the selection of the surgical technique and the decision to convert to pneumoperitoneum.
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© 2024 THE JAPANESE ASSOCIATION OF RURAL MEDICINE
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