Acute appendicitis is one of the most frequent abdominal surgical emergencies. Intra-abdominal abscess is a frequent post-operative complication. The aim of this meta-analysis was to compare peritoneal irrigation and suction versus suction only when performing appendectomy for complicated appendicitis. According to PRISMA guidelines, a systematic review was conducted and registered into the Prospero register (CRD42020186848). The risk of bias was defined to be from low to moderate. Seventeen studies (9 RCTs and 8 CCTs) were selected, including 5315 patients. There was no statistical significance in post-operative intra-abdominal abscess in open (RR 1.27, 95% CI 0.75–2.15; I2 = 74%) and laparoscopic group (RR 1.51, 95% CI 0.73–3.13; I2 = 83%). No statistical significance in reoperation rate in open (RR 1.27, 95% CI 0.04–2.49; I2 = 18%) and laparoscopic group (RR 1.42, 95% CI 0.64–2.49; I2 = 18%). In both open and laparoscopic groups, operative time was lower in the suction group (RR 7.13, 95% CI 3.14–11.12); no statistical significance was found for hospital stay (MD − 0.39, 95% CI − 1.07 to 0.30; I2 = 91%) and the rate of wound infection (MD 1.16, 95% CI 0.56–2.38; I2 = 71%). This systematic review has failed to demonstrate the statistical superiority of employing intra-operative peritoneal irrigation and suction over suction-only to reduce the rate of post-operative complications after appendectomy, but all the articles report clinical superiority in terms of post-operative abscess, wound infection and operative times in suction-only group.

中文翻译：

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阑尾炎抽吸与腹腔灌洗：一项荟萃分析


急性阑尾炎是最常见的腹部外科急症之一。腹腔脓肿是术后常见的并发症。这项荟萃分析的目的是比较腹膜冲洗和抽吸与仅在对复杂性阑尾炎进行阑尾切除术时进行抽吸。根据 PRISMA 指南，进行了系统审查并注册到 Prospero 登记册（CRD42020186848）中。偏倚风险被定义为从低到中。选择了 17 项研究（9 项 RCT 和 8 项 CCT），包括 5315 名患者。开腹组（RR 1.27，95% CI 0.75-2.15；I2 = 74%）和腹腔镜组（RR 1.51，95% CI 0.73-3.13；I2 = 83%）术后腹内脓肿没有统计学意义。 。开腹组（RR 1.27，95% CI 0.04–2.49；I2 = 18%）和腹腔镜组（RR 1.42，95% CI 0.64–2.49；I2 = 18%）的再手术率无统计学意义。在开腹组和腹腔镜组中，抽吸组的手术时间较短（RR 7.13，95% CI 3.14-11.12）；住院时间（MD = 0.39，95% CI = 1.07至0.30；I2 = 91%）和伤口感染率（MD = 1.16，95% CI 0.56–2.38；I2 = 71%）没有发现统计学意义。这项系统评价未能证明术中腹膜冲洗和抽吸相对于单纯抽吸在降低阑尾切除术后术后并发症发生率方面的统计学优越性，但所有文章都报告了在术后脓肿方面的临床优越性，仅抽吸组的伤口感染和手术时间。