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https://www.readbyqxmd.com/read/29200067/randomized-clinical-trial-of-preoperative-high-dose-methylprednisolone-on-postoperative-pain-at-rest-after-laparoscopic-appendectomy
#1
Jakob Kleif, Camilla I Hauge, Jesper Vilandt, Ismail Gögenur
BACKGROUND: Methylprednisolone administered intravenously preoperatively has been shown to reduce pain, nausea, and fatigue after elective surgery. We aimed to show that 125 mg of methylprednisolone given intravenously 30 minutes before laparoscopic surgery for suspected appendicitis would reduce pain at rest during the first 3 postoperative days. METHODS: A multicenter, parallel-group, double-blind, placebo-controlled study was conducted including patients 18 years of age and older with an American Society of Anesthesiologist class of I-III undergoing laparoscopic surgery for suspected appendicitis...
November 30, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29190038/closure-methods-of-the-appendix-stump-for-complications-during-laparoscopic-appendectomy
#2
REVIEW
Gurdeep S Mannu, Maria K Sudul, Joao H Bettencourt-Silva, Elspeth Cumber, Fangfang Li, Allan B Clark, Yoon K Loke
BACKGROUND: Laparoscopic appendectomy is amongst the most common general surgical procedures performed in the developed world. Arguably, the most critical part of this procedure is effective closure of the appendix stump to prevent catastrophic intra-abdominal complications from a faecal leak into the abdominal cavity. A variety of methods to close the appendix stump are used worldwide; these can be broadly divided into traditional ligatures (such as intracorporeal or extracorporeal ligatures or Roeder loops) and mechanical devices (such as stapling devices, clips, or electrothermal devices)...
November 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29183522/peripheral-nerve-injury-during-abdominal-pelvic-surgery-analysis-of-the-national-surgical-quality-improvement-program-database
#3
Christopher J D Wallis, Sarah Peltz, James Byrne, Jamie Kroft, Paul Karanicolas, Natalie Coburn, Avery B Nathens, Robert K Nam, Julie Hallet, Raj Satkunasivam
Peripheral nerve injury (PNI) is a rare but preventable complication of surgery. We sought to assess whether the use of minimally invasive surgery (MIS) affects the occurrence of PNI. Using the American College of Surgeons National Surgical Quality Improvement Program database, we examined rates of PNI among patients undergoing appendectomy, hysterectomy, colectomy, or radical prostatectomy between 2005 and 2012. We assessed the effect of MIS, as compared with open surgery, on PNI occurrence using logistic regression...
November 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29180172/early-appendectomy-reduces-costs-in-children-with-perforated-appendicitis
#4
Joseph T Church, Edwin J Klein, Benjamin D Carr, Steven W Bruch
BACKGROUND: Perforated appendicitis can be managed with early appendectomy, or nonoperative management followed by interval appendectomy. We aimed to identify the strategy with the lowest health care utilization and cost. METHODS: We retrospectively reviewed the medical records of all children ≤18 years old with perforated appendicitis admitted to a single institution between January 2009 and March 2016. After excluding immunosuppressed patients and transfers from outside hospitals, we grouped the remaining patients by early or interval appendectomy...
December 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29143092/laparoscopic-appendectomy-minimally-invasive-surgery-training-improves-outcomes-in-basic-laparoscopic-procedures
#5
Katherine D Gray, Joshua G Burshtein, Lama Obeid, Maureen D Moore, Gregory Dakin, Alfons Pomp, Cheguevara Afaneh
BACKGROUND: To determine whether minimally invasive surgery (MIS) training improves outcomes in laparoscopic appendectomy, a procedure that is commonly performed in general surgery training. METHODS: Retrospective review was conducted of all patients undergoing laparoscopic appendectomy for suspected acute appendicitis between 2014 and 2015 at a single-center, tertiary-care academic institution. Patients operated on by MIS-trained surgeons (MIS group) were compared to those operated on by general surgeons (GS group)...
November 15, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29100591/outcomes-of-complicated-appendicitis-is-conservative-management-as-smooth-as-it-seems
#6
Katelyn A Young, Nina M Neuhaus, Marcus Fluck, Joseph A Blansfield, Marie A Hunsinger, Mohsen M Shabahang, Denise M Torres, Kenneth A Widom, Jeffrey L Wild
BACKGROUND: This study characterized the failure rate of non-operative management (NOM) for complicated appendicitis (CA; perforation, abscess, phlegmon), and compared outcomes among patients undergoing acute appendectomy (AA), elective interval appendectomy (EIA), and unplanned appendectomy after failing to improve with NOM. METHODS: Adults treated at one facility between 2007 and 2014 were retrospectively studied. RESULTS: Ninety-five patients presented with CA...
October 31, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/29100501/trends-in-diagnostic-approaches-for-pediatric-appendicitis-nationwide-population-based-study
#7
Chih-Cheng Luo, Wen-Kuei Chien, Chen-Sheng Huang, Hung-Chieh Lo, Sheng-Mao Wu, Hung-Chang Huang, Ray-Jade Chen, Hsun-Chin Chao
BACKGROUND: To define the benefits of different methods for diagnosis of pediatric appendicitis in Taiwan, a nationwide cohort study was used for analysis. METHODS: We identified 44,529 patients under 18 years old who had been hospitalized with a diagnosis of acute appendicitis between 2003 and 2012. We analyzed the percentages of cases in which ultrasound (US) and/or computed tomography (CT) were performed and non-perforated and perforated appendicitis were diagnosed for each year...
November 3, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/29058569/surgical-site-infections-after-appendectomy-performed-in-low-and-middle-human-development-index-countries-a-systematic-review
#8
Deshka Foster, Will Kethman, Lawrence Z Cai, Thomas G Weiser, Joseph D Forrester
BACKGROUND: Acute appendicitis is a common surgical emergency worldwide. Early intervention is associated with better outcomes. In low and middle Human Development-Index Countries (LMHDICs), late presentation and poor access to healthcare facilities can contribute to greater illness severity and higher complication rates, such as post-operative surgical site infections (SSIs). The current rate of SSIs post-appendectomy in low- and middle-index settings has yet to be described. METHODS: We performed a systemic review of the literature describing the incidence and management of SSIs after appendectomy in LMHDICs...
October 23, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28985855/safety-of-perioperative-ketorolac-administration-in-pediatric-appendectomy
#9
Hibbut-Ur-Rauf Naseem, Robert Michael Dorman, George Ventro, David H Rothstein, Kaveh Vali
BACKGROUND: Recent studies in adults undergoing gastrointestinal surgeries show an increased rate of complications with the use of ketorolac. This calls into question the safety of ketorolac in certain procedures. We sought to evaluate the impact of perioperative ketorolac administration on outcomes in pediatric appendectomy. METHODS: The Pediatric Health Information System database was queried for patients aged 5-17 y with a primary diagnosis of appendicitis and a primary procedure of appendectomy during the period 2010-2014...
October 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28942236/increased-incidence-of-bowel-cancer-after-non-surgical-treatment-of-appendicitis
#10
Malin Enblad, Helgi Birgisson, Anders Ekbom, Fredrik Sandin, Wilhelm Graf
BACKGROUND: There is an ongoing debate on the use of antibiotics instead of appendectomy for treating appendicitis but diagnostic difficulties and longstanding inflammation might lead to increased incidence of bowel cancer in these patients. The aim of this population-based study was to investigate the incidence of bowel cancer after non-surgical treatment of appendicitis. PATIENTS AND METHODS: Patients diagnosed with appendicitis but lacking the surgical procedure code for appendix removal were retrieved from the Swedish National Inpatient Register 1987-2013...
September 7, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28932077/laparoscopic-appendectomy-for-acute-appendicitis-how-to-discourage-surgeons-using-inadequate-therapy
#11
REVIEW
Tomohide Hori, Takafumi Machimoto, Yoshio Kadokawa, Toshiyuki Hata, Tatsuo Ito, Shigeru Kato, Daiki Yasukawa, Yuki Aisu, Yusuke Kimura, Maho Sasaki, Yuichi Takamatsu, Taku Kitano, Shigeo Hisamori, Tsunehiro Yoshimura
Acute appendicitis (AA) develops in a progressive and irreversible manner, even if the clinical course of AA can be temporarily modified by intentional medications. Reliable and real-time diagnosis of AA can be made based on findings of the white blood cell count and enhanced computed tomography. Emergent laparoscopic appendectomy (LA) is considered as the first therapeutic choice for AA. Interval/delayed appendectomy at 6-12 wk after disease onset is considered as unsafe with a high recurrent rate during the waiting time...
August 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28922252/clinical-predictors-and-natural-history-of-disease-extension-in-patients-with-ulcerative-proctitis
#12
Emily Walsh, Young Wha Chah, Samantha M Chin, Paul Lochhead, Vijay Yajnik, Vera Denmark, John J Garber, Hamed Khalili
BACKGROUND: A proportion of patients with initial presentation of ulcerative proctitis (UP) progress to more extensive colitis. We sought to characterize the natural history and identify clinical predictors of extension in UP. METHODS: We performed a retrospective cohort study of participants with a new diagnosis of UP from January 2000 to December 2015. We used Cox proportional hazard modeling to identify predictors of disease extension. RESULTS: We identified 169 new cases of UP with a median age of diagnosis of 40 years (range: 16-91 yr) and a median follow-up of 4...
November 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28891829/laparoscopic-procedure-is-not-independently-associated-with-the-development-of-intra-abdominal-abscess-after-appendectomy-a-multicenter-cohort-study-with-propensity-score-matching-analysis
#13
Jianguo Cao, Feng Tao, Hao Xing, Jun Han, Xiaojun Zhou, Tinghao Chen, Hong Wang, Zhizhou Li, Yahao Zhou, Shusheng Wang, Tian Yang
AIM: The aim of this study was to identify independent risk factors for postoperative intra-abdominal abscess (IAA) after appendectomy for patients with acute appendicitis. BACKGRAOUND: Although laparoscopic appendectomy (LA) has been performed universally, whether LA is associated with an increased incidence of postoperative IAA compared with open appendectomy (OA) remains controversial, which causes some surgeons' increasing concerns. METHODS: We retrospectively analyzed 6805 consecutive adult patients with acute appendicitis who underwent LA or OA at 7 general hospitals in China...
October 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28864100/optimal-stump-management-in-laparoscopic-appendectomy-a-network-meta-analysis-by-the-minimally-invasive-surgery-synthesis-of-interventions-and-outcomes-network
#14
REVIEW
Stavros A Antoniou, Dimitrios Mavridis, Shahab Hajibandeh, Shahin Hajibandeh, George A Antoniou, Ramon Gorter, Mark Tenhagen, Christos Koutras, Rudolph Pointner, George E Chalkiadakis, Frank-Alexander Granderath, George F Fragiadakis, Anastas E Philalithis, Hendrik Jaap Bonjer
BACKGROUND: Laparoscopic appendectomy is the predominant method of treatment of acute appendicitis. There is insufficient evidence on the most effective management of the appendix stump. The aim of this study was to investigate the relative effectiveness and provide a treatment ranking of different options for securing the appendix stump. METHODS: Electronic databases were searched to identify randomized controlled trials comparing ligation methods of the appendix...
November 2017: Surgery
https://www.readbyqxmd.com/read/28831698/utility-of-appendiceal-calcifications-detected-on-computed-tomography-as-a-predictor-for-an-underlying-appendiceal-epithelial-neoplasm
#15
Tara L Sagebiel, Amr Mohamed, Aurelio Matamoros, Melissa W Taggart, Fred Doamekpor, Kanwal P Raghav, Gary N Mann, Paul F Mansfield, Cathy Eng, Richard E Royal, Wai Chin Foo, Joe E Ensor, Keith F Fournier, Michael J Overman
BACKGROUND: Mucinous appendiceal neoplasms can contain radiopaque calcifications. Whether appendiceal radiographic calcifications indicate the presence of an appendiceal epithelial neoplasm is unknown. This study aimed to determine whether appendiceal calcifications detected by computed tomography (CT) correlate with the presence of appendiceal epithelial neoplasms. METHODS: From prospective appendiceal and pathology databases, 332 cases of appendiceal neoplasm and 136 cases of control appendectomy were identified, respectively...
November 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28815859/performance-of-mri-for-suspected-appendicitis-in-pediatric-patients-and-negative-appendectomy-rate-a-systematic-review-and-meta-analysis
#16
Jeong Rye Kim, Chong Hyun Suh, Hee Mang Yoon, Ah Young Jung, Jin Seong Lee, Jung Heon Kim, Jeong-Yong Lee, Young Ah Cho
PURPOSE: To evaluate in pediatric patients the diagnostic performance of magnetic resonance imaging (MRI) for suspected appendicitis and its negative appendectomy rate. MATERIALS AND METHODS: The study involved diagnostic accuracy studies that used MRI for pediatric patients with suspected appendicitis. Various field strengths and sequences were used in each included study. The diagnostic accuracy of MRI in pediatric patients with suspected appendicitis and negative appendectomy rate were assessed...
August 17, 2017: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/28814624/outcomes-of-nonoperative-management-of-uncomplicated-appendicitis
#17
Richard G Bachur, Susan C Lipsett, Michael C Monuteaux
BACKGROUND AND OBJECTIVES: Nonoperative management (NOM) of uncomplicated pediatric appendicitis has promise but remains poorly studied. NOM may lead to an increase in resource utilization. Our objective was to investigate the trends in NOM for uncomplicated appendicitis and study the relevant clinical outcomes including subsequent appendectomy, complications, and resource utilization. METHODS: Retrospective analysis of administrative data from 45 US pediatric hospitals...
June 2, 2017: Pediatrics
https://www.readbyqxmd.com/read/28807192/does-compliance-with-antibiotic-prophylaxis-in-pediatric-simple-appendicitis-matter
#18
Krislynn M Mueck, Luke R Putnam, Kathryn T Anderson, Kevin P Lally, KuoJen Tsao, Lillian S Kao
BACKGROUND: Institutional protocols for preincisional antibiotic prophylaxis can standardize care and improve outcomes. However, challenges remain in compliance with such protocols for urgent or emergent operations. We hypothesized that compliance with an institutional protocol for antibiotic prophylaxis for appendectomy for appendicitis in pediatric patients results in reduced surgical site infections (SSIs) after simple appendectomy. METHODS: This retrospective study assessed all pediatric patients (≤18 y) who underwent appendectomy for confirmed simple appendicitis at a tertiary children's hospital between 2012 and 2015...
August 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28796014/comparison-of-superficial-surgical-site-infection-between-delayed-primary-versus-primary-wound-closure-in-complicated-appendicitis-a-randomized-controlled-trial
#19
Boonying Siribumrungwong, Anuwat Chantip, Pinit Noorit, Chumpon Wilasrusmee, Winai Ungpinitpong, Pradya Chotiya, Borwornsom Leerapan, Patarawan Woratanarat, Mark McEvoy, John Attia, Ammarin Thakkinstian
OBJECTIVE: To compare superficial surgical site infection (SSI) rates between delayed primary wound closure (DPC) and primary wound closure (PC) for complicated appendicitis. BACKGROUND: SSI is common in appendectomy for complicated appendicitis. DPC is preferentially used over PC, but its efficacy is still controversial. METHODS: A multicenter randomized controlled trial was conducted in 6 hospitals in Thailand, enrolling patients with gangrenous and ruptured appendicitis...
August 4, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28794868/feasibility-and-safety-of-surgical-wound-remote-follow-up-by-smart-phone-in-appendectomy-a-pilot-study
#20
Juan José Segura-Sampedro, Inés Rivero-Belenchón, Verónica Pino-Díaz, María Cristina Rodríguez Sánchez, Felipe Pareja-Ciuró, Javier Padillo-Ruiz, Rosa María Jimenez-Rodriguez
INTRODUCTION: The objective of the present study is to assess the safety and feasibility of the use of telemedicine-based services for surgical wound care and to measure patient satisfaction with telemedicine-based follow-up. MATERIAL AND METHODS: 24 patients were included, they were provided with a corporate mail address. On day 7 after surgery patients sent, via email, an image of their surgical wound together with a completed questionnaire in order to obtain an early diagnosis...
September 2017: Annals of Medicine and Surgery
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