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https://www.readbyqxmd.com/read/28092251/-acute-appendicitis-surgical-and-non-surgical-treatment
#1
Luis Manuel Souza-Gallardo, José Luis Martínez-Ordaz
Appendicitis represents a common disease for the surgeon with a relative risk between 7-8%. It was thought that if more time passed between diagnosis and treatment, the risk for complications, such as perforation or abscess formation, was higher; nevertheless; the evolution is variable, making necessary the development of different strategies such as antibiotic use only, interval surgery or endoscopic treatment. The purpose of this study is to make a revision in the management of appendicitis comparing conservative and surgical treatment...
January 2017: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/28089500/c-reactive-protein-may-predict-the-recurrence-of-appendicitis-in-children-formerly-with-appendiceal-mass-after-successful-non-operative-treatment
#2
Yi-Jung Chang, Hsun-Chin Chao, Chyi-Liang Chen, Shin-Yann Chen, Dah-Chin Yan, Ming-Han Tsai
BACKGROUND: This study identified factors associated with the recurrence of appendicitis in children with appendiceal masses after successful nonsurgical treatment. METHODS: In this retrospective study, children who were diagnosed as having appendiceal masses after undergoing conservative treatment between 2000 and 2014 were enrolled and the medical records of those who did not undergo an interval appendectomy were reviewed. The clinical features and outcomes of patients with and those without recurrent appendicitis were compared...
December 15, 2016: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28060232/a-dedicated-orthopaedic-trauma-operating-room-improves-efficiency-at-a-pediatric-center
#3
Christopher M Brusalis, Apurva S Shah, Xianqun Luan, Meaghan K Lutts, Wudbhav N Sankar
BACKGROUND: Dedicated orthopaedic trauma operating rooms have improved operating room efficiency, physician schedules, and patient outcomes in adult populations. The purpose of this study was to determine if a dedicated orthopaedic trauma operating room was associated with improved patient flow and cost savings at a level-I pediatric trauma center. METHODS: A retrospective analysis was performed for two 3-year intervals before and after implementation of a weekday, unbooked operating room reserved for orthopaedic trauma cases...
January 4, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28049215/surgical-management-of-endometriosis-in-patients-with-chronic-pelvic-pain
#4
Rebecca Flyckt, Suejin Kim, Tommaso Falcone
Surgical approaches to endometriosis patients with chronic pelvic pain are multimodal and require individualization. Laparoscopic approaches are preferred over laparotomy when conservatively treating endometriosis via excision or ablation/fulguration of lesions. The available data support cystectomy over fenestration or fulguration for endometriomas; however, there may be associated decreases in ovarian reserve with endometrioma treatment. Presacral neurectomy may be useful in patients with midline pain and LUNA is not effective for the treatment of pelvic pain related to endometriosis...
January 3, 2017: Seminars in Reproductive Medicine
https://www.readbyqxmd.com/read/28039865/sonographic-differentiation-of-complicated-from-uncomplicated-appendicitis-implications-for-antibiotics-first-therapy
#5
Yingding Xu, R Brooke Jeffrey, Stephanie T Chang, Michael A DiMaio, Eric W Olcott
OBJECTIVES: To evaluate sonographic findings as indicators of complicated versus uncomplicated appendicitis in the setting of known appendicitis, a necessary distinction in deciding whether to proceed with antibiotic therapy or with appendectomy. METHODS: With Institutional Review Board approval and Health Insurance Portability and Accountability Act compliance, appendiceal sonograms of 119 patients with histopathologically proven appendicitis were retrospectively blindly reviewed to determine the presence or absence of the normally echogenic submucosal layer, the presence of mural hyperemia, periappendiceal fluid, appendicoliths, and hyperechoic periappendiceal fat and to determine the maximum outside diameter...
December 31, 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28009537/overweight-and-obese-pediatric-patients-have-an-increased-risk-of-developing-a-surgical-site-infection
#6
Brian P Blackwood, Colin D Gause, Jamie C Harris, Christina M Theodorou, Irene Helenowski, Timothy B Lautz, Julia Grabowski, Catherine J Hunter
BACKGROUND: Obesity is a known risk factor in adult surgical site infections (SSIs), but its significance in pediatrics is unclear. We hypothesized that overweight and obese children have increased risk for SSI. PATIENTS AND METHODS: A National Surgical Quality Improvement Program-Pediatric (NSQIP-P) file and single-center reviews identified surgical patients (2-18 years) who developed SSIs. Patients were classified as underweight, normal, overweight, or obese based on body mass index (BMI)...
December 23, 2016: Surgical Infections
https://www.readbyqxmd.com/read/27974169/antibiotics-first-versus-surgery-for-appendicitis-a%C3%A2-us-pilot-randomized-controlled-trial-allowing-outpatient-antibiotic-management
#7
David A Talan, Darin J Saltzman, William R Mower, Anusha Krishnadasan, Cecilia M Jude, Ricky Amii, Daniel A DeUgarte, James X Wu, Kavitha Pathmarajah, Ashkan Morim, Gregory J Moran
STUDY OBJECTIVE: Randomized trials suggest that nonoperative treatment of uncomplicated appendicitis with antibiotics-first is safe. No trial has evaluated outpatient treatment and no US randomized trial has been conducted, to our knowledge. This pilot study assessed feasibility of a multicenter US study comparing antibiotics-first, including outpatient management, with appendectomy. METHODS: Patients aged 5 years or older with uncomplicated appendicitis at 1 US hospital were randomized to appendectomy or intravenous ertapenem greater than or equal to 48 hours and oral cefdinir and metronidazole...
December 11, 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/27919452/imaging-gently-higher-rates-of-computed-tomography-imaging-for-pediatric-appendicitis-in-non-children-s-hospitals
#8
K Tinsley Anderson, Luke R Putnam, Kelly M Caldwell, Michael B Diffley, Aubrey A Hildebrandt, Sarah E Covey, Mary T Austin, Akemi L Kawaguchi, Kevin P Lally, KuoJen Tsao
BACKGROUND: Growing concerns regarding radiation exposure in children have led to recommendations to minimize computed tomography imaging for appendicitis. We hypothesized that within a metropolitan hospital system (1 children's hospital and 8 non-children's hospitals), use of preoperative computed tomography is much greater in non-children's hospitals. METHODS: We conducted a retrospective study of patients <18 years of age undergoing appendectomy for acute appendicitis from April 2012 to April 2015...
December 2, 2016: Surgery
https://www.readbyqxmd.com/read/27916376/factors-predictive-of-complicated-appendicitis-in-children
#9
Xuan-Binh D Pham, Veronica F Sullins, Dennis Y Kim, Blake Range, Amy H Kaji, Christian M de Virgilio, Steven L Lee
BACKGROUND: The ability to predict whether a child has complicated appendicitis at initial presentation may influence clinical management. However, whether complicated appendicitis is associated with prehospital or inhospital factors is not clear. We also investigate whether hyponatremia may be a novel prehospital factor associated with complicated appendicitis. MATERIALS AND METHODS: A retrospective review of all pediatric patients (≤12 y) with appendicitis treated with appendectomy from 2000 to 2013 was performed...
November 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27884613/appendectomy-in-patients-with-human-immunodeficiency-virus-not-as-bad-as-we-once-thought
#10
Michael C Smith, Paul J Chung, Yohannes C Constable, Matthew R Boylan, Antonio E Alfonso, Gainosuke Sugiyama
BACKGROUND: The number of patients living with human immunodeficiency virus and acquired immunodeficiency syndrome is growing due to advances in antiretroviral therapy. Existing literature on appendectomy within this patient population has been limited by small sample sizes. Therefore, we used a large, multiyear, nationwide database to study this topic comprehensively. METHODS: Using the Nationwide Inpatient Sample, we identified 338,805 patients between 2005 and 2012 who underwent laparoscopic or open appendectomy for acute appendicitis...
November 21, 2016: Surgery
https://www.readbyqxmd.com/read/27884328/effects-of-diagnosis-related-group-payment-system-on-appendectomy-outcomes
#11
Tae Hyun Kim, Eun-Cheol Park, Sung-In Jang, Suk-Yong Jang, Sang Ah Lee, Jae Woo Choi
BACKGROUND: The voluntary diagnosis-related group (DRG) payment system was introduced in 2002. Since July 2013, the Korean government has mandated DRG participation for all hospitals. The main purpose of this study was to examine the effects of mandatory DRG participation on various outcome metrics for appendectomy patients. MATERIALS AND METHODS: We collected inpatient DRG data for 280,062 appendectomy patients between 2007 and 2014 using the Health Insurance Review and Assessment database...
December 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27864617/diagnostic-accuracy-of-abdominal-ultrasound-for-diagnosis-of-acute-appendicitis-systematic-review-and-meta-analysis
#12
Vanja Giljaca, Tin Nadarevic, Goran Poropat, Vesna Stefanac Nadarevic, Davor Stimac
BACKGROUND: To determine the diagnostic accuracy of abdominal ultrasound (US) for the diagnosis of acute appendicitis (AA), in terms of sensitivity, specificity and post-test probabilities for positive and negative result. METHODS: A systematic search of MEDLINE, Embase, The Cochrane library and Science Citation Index Expanded from January 1994 to October 2014 was performed. Two authors independently evaluated studies for inclusion, extracted data and performed analyses...
November 18, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27816201/fast-track-pathway-for-perforated-appendicitis
#13
Richard Frazee, Stephen Abernathy, Matthew Davis, Travis Isbell, Justin Regner, Randall Smith
BACKGROUND: Perforated appendicitis is associated with an increased morbidity and length of stay. "Fast track" protocols have demonstrated success in shortening hospitalization without increasing morbidity for a variety of surgical processes. This study evaluates a fast track pathway for perforated appendicitis. METHODS: In 2013, a treatment pathway for perforated appendicitis was adopted by the Acute Care Surgery Service for patients having surgical management of perforated appendicitis...
October 20, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27788918/comparison-of-outcomes-of-patients-with-acute-appendicitis-between-an-acute-care-surgery-model-and-traditional-call-coverage-model-in-the-same-community
#14
Shaina Schaetzel, Rachel Dirks, James Davis
BACKGROUND: This study compared outcomes, patient flow, and cost between an acute care surgery (ACS) and traditional call model (TRAD) for acute appendicitis in the same community and time period. METHODS: Patients who underwent appendectomy from 7/1/2012 to 6/30/2014 were retrospectively reviewed. An ACS and TRAD were compared. Demographic data, outcomes, cost, and time intervals were compared. RESULTS: Of the 945 patients reviewed, the ACS group had more perforated appendicitis on preoperative computed tomography scan (9% vs 3%, P < ...
December 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27785727/establishing-a-pediatric-robotic-surgery-program-in-canada
#15
Andreana Bütter, Neil Merritt, Sumit Dave
Despite the introduction of robotic surgery in 2000, few pediatric surgeons outside the United States have embraced this technology. We discuss our experience with establishing the first Canadian pediatric robotic surgery program. After simulator training, live animal surgery and observation of robotically assisted cases at an outside institution, we performed our first pediatric da Vinci(®) surgery in July 2013. A prospective database was established to assess outcomes. Forty one children have undergone robotically assisted surgery for the following 42 procedures: (a) pyeloplasty (17), (b) ureteral reimplantations (12), (c) uretero-uretostomy (1), (d) cholecystectomies (10), (e) interval appendectomy (1) and (f) distal pancreatectomy (1)...
October 26, 2016: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/27779999/appendicitis-in-cancer-patients-is-often-observed-and-can-represent-appendiceal-malignancy
#16
David Santos, Yi-Ju Chiang, Brian Badgwell
Appendectomy is standard of care for uncomplicated appendicitis, but cancer patients may not be optimal surgical candidates. Interval appendectomy is controversial, and appendiceal malignancy is rare. Study objectives were to review the role of surgery, observation, and interventional radiology (IR)-guided drainage in patients with appendicitis and advanced malignancy. Retrospective review was performed on cancer patients presenting to a tertiary academic cancer center from January 1, 2001 to December 31, 2014...
October 2016: American Surgeon
https://www.readbyqxmd.com/read/27779966/does-incidental-appendectomy-increase-the-risk-of-complications-after-abdominal-procedures
#17
Mohammed Al-Temimi, Charles Trujillo, John Agapian, Hanna Park, Ahmad Dehal, Samir Johna, Deron Tessier
Incidental appendectomy (IA) could potentially increase the risk of morbidity after abdominal procedures; however, such effect is not clearly established. The aim of our study is to test the association of IA with morbidity after abdominal procedures. We identified 743 (0.37%) IA among 199,233 abdominal procedures in the National Surgical Quality Improvement Program database (2005-2009). Cases with and without IA were matched on the index current procedural terminology code. Patient characteristics were compared using chi-squared test for categorical variables and Student t test for continuous variables...
October 2016: American Surgeon
https://www.readbyqxmd.com/read/27775295/-conservative-or-early-surgical-management-of-appendiceal-mass-does-it-affect-the-appearance-of-complications
#18
F J Murcia Pascual, J I Garrido Pérez, V Vargas Cruz, J E Betancourth Alvarenga, M A Cárdenas Elías, F Vázquez Rueda, R M Paredes Esteban
OBJECTIVES: Currently the management of appendicular mass remains controversial. Many authors advocate conservative management followed by delayed appendectomy, whereas others favour inmediate appendectomy. The aim of our study is to compare both treatments. METHODS: A descriptive and observational study over 46 patients treated for appendiceal mass at our center in the last ten years was performed. Patients were categorized as group 1, early surgical intervention (54...
October 10, 2015: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/27759621/antibiotics-versus-surgical-therapy-for-uncomplicated-appendicitis-systematic-review-and-meta-analysis-of-controlled-trials-prospero-2015-crd42015016882
#19
Julian C Harnoss, Isabelle Zelienka, Pascal Probst, Kathrin Grummich, Catharina Müller-Lantzsch, Jonathan M Harnoss, Alexis Ulrich, Markus W Büchler, Markus K Diener
OBJECTIVE: The aim was to investigate available evidence regarding effectiveness and safety of surgical versus conservative treatment of acute appendicitis. SUMMARY OF BACKGROUND DATA: There is ongoing debate on the merits of surgical and conservative treatment for acute appendicitis. METHODS: A systematic literature search (Cochrane Library, Medline, Embase) and hand search of retrieved reference lists up to January 2016 was conducted to identify randomized and nonrandomized studies...
October 17, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27756415/borderline-ovarian-tumors-clinical-characteristics-management-and-outcomes-a-multicenter-study
#20
Mehmet Gokcu, Kemal Gungorduk, Osman Aşıcıoğlu, Nilüfer Çetinkaya, Tayfun Güngör, Gonca Pakay, Zeliha Fırat Cüylan, Tayfun Toptaş, Ramazan Özyurt, Elif Ağaçayak, Aykut Ozdemir, Onur Erol, Anıl Turan, Varol Gülseren, Mehmet Sait İcen, Taylan Şenol, Hakan Güraslan, Burcu Yücesoy, Ahmet Sahbaz, Ozgu Gungorduk, Berhan Besimoğlu, Kaan Pakay, Osman Temizkan, Muzaffer Sancı, Tayup Şimşek, Mehmet Mutlu Meydanlı, Mehmet Harma, Levent Yaşar, Birtan Boran, Aysel Derbent Uysal, Ateş Karateke
BACKGROUND: The optimal surgical management and staging of borderline ovarian tumors (BOTs) are controversial. Institutions have different surgical approaches for the treatment of BOTs. Here, we performed a retrospective review of clinical characteristics, surgical management and surgical outcomes, and sought to identify variables affecting disease-free survival (DFS) and overall survival (OS) in patients with BOTs. METHODS: A retrospective review of ten gynecological oncology department databases in Turkey was conducted to identify patients diagnosed with BOTs...
October 18, 2016: Journal of Ovarian Research
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