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Ethics code: IR.MUBAM.REC.1403.099
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Salehi A, Moshki E, Malekian L, Nozari M, Ansari Shiri M. Midline versus McBurney Incision for Interval Appendectomy after Complicated Appendicitis: A Retrospective Cohort Study in a Resource-Limited Center. , Mod Care J. 2026; 23 (4)
URL: http://mcj.bums.ac.ir/article-1-619-en.html
URL: http://mcj.bums.ac.ir/article-1-619-en.html
1- Faculty of Medicine, Bam University of Medical Sciences, Bam, Iran.
2- Student of Medicine, Bam University of Medical Sciences, Bam, Iran.
3- Pasteur Teaching Hospital, Bam University of Medical Sciences, Bam, Iran.
4- Department of Environmental Health Engineering, School of Public Health, Bam University of Medical Sciences, Bam, Iran.
5- Noncommunicable Diseases Research Center, Bam University of Medical Sciences, Bam, Iran. ,marziyehansarishiri566@gmail.com.
2- Student of Medicine, Bam University of Medical Sciences, Bam, Iran.
3- Pasteur Teaching Hospital, Bam University of Medical Sciences, Bam, Iran.
4- Department of Environmental Health Engineering, School of Public Health, Bam University of Medical Sciences, Bam, Iran.
5- Noncommunicable Diseases Research Center, Bam University of Medical Sciences, Bam, Iran. ,
Abstract: (7 Views)
Introduction: In settings without routine laparoscopic access, open appendectomy remains the standard approach for interval appendectomy after complicated appendicitis, but the effects of midline laparotomy versus McBurney incision on postoperative outcomes have not been directly compared.
Objectives: This study compared midline laparotomy and McBurney incision in terms of intraoperative adhesions, postoperative complications, antibiotic duration, hospital stay, and readmission in patients undergoing interval appendectomy.
Methods: In this retrospective cohort study, all patients with conservatively managed complicated appendicitis (peri-appendiceal abscess or phlegmon) who subsequently underwent interval appendectomy via midline laparotomy or McBurney incision at Pasteur Hospital, Bam, between April 2024 and March 2025 were enrolled by census sampling according to predefined inclusion and exclusion criteria. Data were extracted from surgical and follow-up records using a standardized form. Groups were compared using the chi-square and Mann-Whitney U tests in IBM SPSS version 26, with significance set at p < 0.05.
Results: Among 136 patients (68 per group), surgical site infection occurred in 15.4% (15 midline vs. 6 McBurney; p = 0.058) and postoperative bleeding in 11% (11 vs. 4; p = 0.101), with no significant association with incision type. Intraoperative adhesions occurred in 25% of cases (19 vs. 15; p = 0.552). Antibiotic duration was significantly longer in the midline group (5.60 ± 1.59 vs. 4.74 ± 1.30 days, p = 0.002), and hospital stay was significantly shorter in the McBurney group (1.79 ± 0.72 vs. 3.09 ± 1.27 days, p < 0.001). Readmission occurred in 2.9% of patients (4 cases, all midline; p = 0.128).
Conclusions: Both techniques appear effective and safe for interval appendectomy, and McBurney incision was associated with shorter antibiotic use and hospitalization. However, given the retrospective, non-randomized allocation of incision type, these findings should be interpreted cautiously. Larger prospective studies accounting for underlying disease severity are recommended.
Objectives: This study compared midline laparotomy and McBurney incision in terms of intraoperative adhesions, postoperative complications, antibiotic duration, hospital stay, and readmission in patients undergoing interval appendectomy.
Methods: In this retrospective cohort study, all patients with conservatively managed complicated appendicitis (peri-appendiceal abscess or phlegmon) who subsequently underwent interval appendectomy via midline laparotomy or McBurney incision at Pasteur Hospital, Bam, between April 2024 and March 2025 were enrolled by census sampling according to predefined inclusion and exclusion criteria. Data were extracted from surgical and follow-up records using a standardized form. Groups were compared using the chi-square and Mann-Whitney U tests in IBM SPSS version 26, with significance set at p < 0.05.
Results: Among 136 patients (68 per group), surgical site infection occurred in 15.4% (15 midline vs. 6 McBurney; p = 0.058) and postoperative bleeding in 11% (11 vs. 4; p = 0.101), with no significant association with incision type. Intraoperative adhesions occurred in 25% of cases (19 vs. 15; p = 0.552). Antibiotic duration was significantly longer in the midline group (5.60 ± 1.59 vs. 4.74 ± 1.30 days, p = 0.002), and hospital stay was significantly shorter in the McBurney group (1.79 ± 0.72 vs. 3.09 ± 1.27 days, p < 0.001). Readmission occurred in 2.9% of patients (4 cases, all midline; p = 0.128).
Conclusions: Both techniques appear effective and safe for interval appendectomy, and McBurney incision was associated with shorter antibiotic use and hospitalization. However, given the retrospective, non-randomized allocation of incision type, these findings should be interpreted cautiously. Larger prospective studies accounting for underlying disease severity are recommended.
Keywords: Surgery, Complicated Appendicitis, Interval Appendectomy, McBurney Incision, Midline Laparotomy
Article Types: Research Article |
Subject:
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Received: 2026/04/24 | Accepted: 2026/10/11 | Published: 2026/10/18
Received: 2026/04/24 | Accepted: 2026/10/11 | Published: 2026/10/18
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