THE PREDICTIVE ROLE OF SELECTIVE LABORATORY PARAMETERS FOR THE OCCURRENCE OF   “UNWANTED  EVENTS” IN ADULTS WITH  LAPAROSCOPIC  APPENDECTOMY

Ilija Milev; Vesna Velikj Stefanovska; Aleksandar Mitevski; Panche Karagjozov; Marjan Mihailov

Ilija Milev Department of Surgery, Clinical Hospital-Shtip, Faculty of Medical Sciences, Goce Delchev University in Shtip, R.North Macedonia
Vesna Velikj Stefanovska Department of Epidemiology and Biostatistics, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R. North Macedonia
Aleksandar Mitevski Department of Surgery, Re-Medica General Hospital, Faculty of Medical Sciences, Goce Delchev University in Shtip, R. North Macedonia
Panche Karagjozov Clinic for Digestive Surgery, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R. North Macedonia
Marjan Mihailov Department of Anesthesiology, Clinical Hospital-Shtip, R. North Macedonia

Abstract

The aim of our study was to assess the potential predictive role of selected laboratory parameters in recognition of laparoscopic appendectomy (LA) associated with unwanted events defined as intraoperative difficulties, conversion to open approach and early postoperative complications. A multicenter, prospective, clinical study was conducted. 75 randomly selected adults with acute appendicitis were selected as study participants. Twenty-five laboratory parameters were measured for all of them. In 69, LA was performed and in 6 of the patients, a conversion to open appendectomy had to be accomplished. For each patient, we registered the unwanted events in relation to the treatment. Out of 75 participants with LA, 51 (68%) were without and 24 (32%) were with unwanted events. Binary analysis showed significantly higher levels of total bilirubin (p = 0.0228), sodium (p = 0.0161) and C – reactive protein (p = 0.0005) in the group with unwanted events. Multiple logistic regression analysis confirmed the total serum bilirubin as the only independent predictor – OR = 1.079 [p = 0.041, 95% CI = 1.003-1.162]. High levels of C – reactive protein, serum sodium and total serum bilirubin could be indicators of unwanted intraoperative or postoperative course in the patients treated with LA. In such cases it is wise to consider performing the laparoscopic exploration in the presence of an experienced surgeon.

Keywords: laparoscopic appendectomy, C- reactive protein, bilirubin, sodium.

https://doi.org/10.55302/JMS2251064m

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