La coelio-appendicectomie, ce n’est pas pareil que l’appendicectomie conventionnelle: c’est mieux et ce doit être beaucoup mieux. Ou comment réduire le taux des abcès abdominaux secondaires?

Abstract

The realisation today of simple appendicitis and complicated tre atement could not be done without the use of coelioscopy. However some authors are satisfied with rates of 1 to 2% of intra – abdominal sego n d a ry abcesses. The authors think that this rate can only be re l ated to an insufficient training or a bad use of the technique. Many experts have got rates much lower around 0.1-0.2%. These good outcomes are due to an extreme rigour carrying out three potentially iat rogenic stages: a perfect parietal and appendicular meso hemostasis, a perfect closure and condition of the stump, a systematic careful rinsing by washing- aspiration of Douglas pouch, a right iliac fossa and extraction port. To rea+ch this result, a washing- aspirating device is vital. The authors recommend, as often as possibl e, the coelio-assisted procedures "extra – abdominal" and "mixed", fast, sure and inexpensive and giving a lower rate of secondary abcesses, to be compared concerning safety but not costs with systematic use of endo-stapling.

Keywords: Appendicitis, Coelio-appendicectomy, Laparoscopic appendicectomy, postoperat ive intra – abdominal abcesses.)