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https://www.readbyqxmd.com/read/28629607/post-operative-management-of-perforated-appendicitis-can-clinical-pathways-improve-outcomes
#1
Robert R Gerard, Barrett A Kielhorn, Laurence E McCahill, Brent Petersen, Andrew J Mullard
BACKGROUND: We sought to decrease organ space infection (OSI) following appendectomy for perforated acute appendicitis (PAA) by minimizing variation in clinical management. OBJECTIVE: A postoperative treatment pathway was developed and four recommendations were implemented: 1) clear documentation of post-operative diagnosis, 2) patients with unknown perforation status to be treated as perforated pending definitive diagnosis, 3) antibiotic therapy to be continued post operatively for 4-7 days after SIRS resolution, and 4) judicious use of abdominal computed tomography (CT) scanning prior to post-operative day 5...
June 10, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28624044/predictors-of-a-histopathologic-diagnosis-of-complicated-appendicitis
#2
Jonathan B Imran, Tarik D Madni, Christian T Minshall, Ali A Mokdad, Madhu Subramanian, Audra T Clark, Herb A Phelan, Michael W Cripps
BACKGROUND: Despite its utilization, the intraoperative (IO) assessment of complicated appendicitis (CA) is subjective. The histopathologic (HP) diagnosis should be the gold standard in identifying patients with CA; however, it is not immediately available to guide postoperative management. The objective of this study was to identify predictors of an HP diagnosis of CA. MATERIALS AND METHODS: A retrospective review of all patients who underwent appendectomy at our institution from 2011-2013 was conducted...
June 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28610745/the-impact-of-type-and-number-of-bowel-resections-on-anastomotic-leakage-risk-in-advanced-ovarian-cancer-surgery
#3
Christoph Grimm, Philipp Harter, Pier F Alesina, Sonia Prader, Stephanie Schneider, Beyhan Ataseven, Beate Meier, Violetta Brunkhorst, Jakob Hinrichs, Christian Kurzeder, Florian Heitz, Annett Kahl, Alexander Traut, Harald T Groeben, Martin Walz, Andreas du Bois
OBJECTIVE: To identify risk factors for anastomotic leakage (AL) in patients undergoing primary advanced ovarian cancer surgery and to evaluate the prognostic implication of AL on overall survival in these patients. METHODS: We analyzed our institutional database for primary EOC and included all consecutive patients treated by debulking surgery including any type of full circumferential bowel resection beyond appendectomy between 1999 and 2015. We performed logistic regression models to identify risk factors for AL and log-rank tests and Cox proportional hazards models to evaluate the association between AL and survival...
June 10, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28589138/appendectomy-as-a-risk-factor-for-bacteremic-biliary-tract-infection-caused-by-antibiotic-resistant-pathogens
#4
Koki Kawanishi, Jun Kinoshita, Hiroko Abe, Tetsuhiro Kakimoto, Yuko Yasuda, Takeshi Hara, Jun Kato
BACKGROUND/AIMS: Recent evidence has suggested that appendix plays a pivotal role in the development and preservation of intestinal immune system. The aim of this study is to examine whether prior appendectomy is associated with an increased risk for the development of antibiotic-resistant bacteria in bacteremia from biliary tract infection (BTI). METHODS: Charts from 174 consecutive cases of bacteremia derived from BTI were retrospectively reviewed. Using multivariate analysis, independent risk factors for development of antibiotic-resistant bacteria were identified among the clinical parameters, including a history of appendectomy...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28490413/risk-factors-for-appendiceal-involvement-in-women-with-epithelial-ovarian-cancer
#5
Mustafa Erkan Sarı, Elmas Korkmaz, Murat Öz, Tayfun Güngör, Mehmet Mutlu Meydanlı
OBJECTIVE: In this study we aimed to evaluate the risk factors for appendiceal involvement in women with epithelial ovarian cancer (EOC) who underwent appendectomy at the time of initial surgery. MATERIAL AND METHODS: Patients with a final diagnosis of EOC who underwent appendectomy at the time of initial surgery were evaluated retrospectively. Risk factors related to the presence of appendiceal involvement were analyzed. RESULTS: A total of 210 patients underwent appendectomy during staging surgery...
May 11, 2017: Journal of the Turkish German Gynecological Association
https://www.readbyqxmd.com/read/28421569/two-step-procedure-for-complicated-appendicitis-with-perityphlitic-abscess-formation
#6
Almir Miftaroski, Ulf Kessler, Etienne Monnard, Bernhard Egger
PRINCIPLES: Optimal management of perforated appendicitis with perityphlitic phlegmon or abscess formation is controversial. The aim of the study was to assess the outcome after a two-step procedure to treat patients with perityphlitic abscess formation. METHODS: We retrospectively assessed prospectively collected data from a single-centre database that included adult patients who had appendicitis and perityphlitic abscess (>=3 cm) but no generalised peritonitis, and were treated in 2007-2015...
April 19, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28414702/minimally-invasive-treatment-for-appendiceal-mass-formed-after-acute-perforated-appendicitis
#7
Enver Zerem, Suad Kunosić, Almin Handanagić, Dženan Jahić, Dina Zerem, Omar Zerem
The optimal treatment for appendiceal mass formed after appendiceal rupture due to acute appendicitis is surrounded with controversy. The treatment strategy ranges from open surgery (emergency or interval appendectomy), laparoscopic appendectomy, and image-guided drainage, to conservative treatment with or without antibiotics. Nonsurgical treatment (including conservative and drainage treatment), followed by interval appendectomy to prevent recurrence, is the traditional management of these patients. The need for interval appendectomy after a successful conservative or/and image-guided drainage treatment, has recently been questioned as the risk of recurrence is relatively small...
June 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28387683/appendectomy-history-is-not-related-to-parkinson-s-disease
#8
Rezzak Yilmaz, Ece Bayram, Çağrı Ulukan, Mustafa Kemal Altınok, Muhittin Cenk Akbostancı
BACKGROUND: It has been suggested that appendectomy may modify the emergence of Parkinson's disease (PD) by affecting the retrograde transport of α-synuclein (α-syn) from the gastrointestinal system. OBJECTIVE: To explore the possible role of appendectomy on PD. METHODS: The retrospective data of the 1625 patients (839 PD, 633 non-α-syn parkinsonism and 153 controls) were compared. Disease specific measures between PD patients with (n = 69) and without (n = 770) appendectomy were also evaluated...
April 4, 2017: Journal of Parkinson's Disease
https://www.readbyqxmd.com/read/28306630/nonoperative-management-of-appendicitis-in-children
#9
Joseph J López, Katherine J Deans, Peter C Minneci
PURPOSE OF REVIEW: The aim of this review is to summarize the recent literature investigating nonoperative management of uncomplicated and complicated appendicitis and highlight recent data establishing its safety and efficacy. RECENT FINDINGS: Recent studies and clinical trials have demonstrated the efficacy of nonoperative treatment of both uncomplicated and complicated appendicitis, defined as perforated appendicitis with or without formed abscess or phlegmon...
June 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28288060/the-global-incidence-of-appendicitis-a-systematic-review-of-population-based-studies
#10
Mollie Ferris, Samuel Quan, Belle S Kaplan, Natalie Molodecky, Chad G Ball, Greg W Chernoff, Nij Bhala, Subrata Ghosh, Elijah Dixon, Siew Ng, Gilaad G Kaplan
OBJECTIVE: We compared the incidence of appendicitis or appendectomy across the world and evaluated temporal trends. SUMMARY BACKGROUND DATA: Population-based studies reported the incidence of appendicitis. METHODS: We searched MEDLINE and EMBASE databases for population-based studies reporting the incidence of appendicitis or appendectomy. Time trends were explored using Poisson regression and reported as annual percent change (APC) with 95% confidence intervals (CI)...
March 10, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28286544/acute-appendicitis-inflammatory-appendiceal-mass-and-the-risk-of-a-hidden-malignant-tumor-a-systematic-review-of-the-literature
#11
REVIEW
Frederico José Ribeiro Teixeira, Sérgio Dias do Couto Netto, Eduardo Hiroshi Akaishi, Edivaldo Massazo Utiyama, Carlos Augusto Metidieri Menegozzo, Marcelo Cristiano Rocha
INTRODUCTION: Acute appendicitis is significantly common. Despite the increased use of computed tomography, the number of perforated cases has been stable in the past three decades. Between 2% and 6% of patients with acute appendicitis present appendiceal mass, often described as inflammatory phlegmon or abscess. Malignant tumors are confirmed by pathological analysis in 0.9-1.4% of all appendectomies performed to treat acute appendicitis. However, recent series demonstrate an elevated incidence of malignancies, ranging from 5...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28285058/conversion-to-open-in-laparoscopic-appendectomy-a-cohort-analysis-of-risk-factors-and-outcomes
#12
Brendan M Finnerty, Xian Wu, Gregory P Giambrone, Licia K Gaber-Baylis, Ramin Zabih, Akshay Bhat, Rasa Zarnegar, Alfons Pomp, Peter Fleischut, Cheguevara Afaneh
BACKGROUND: Identifying risk factors for conversion from laparoscopic to open appendectomy could select patients who may benefit from primary open appendectomy. We aimed to develop a predictive scoring model for conversion from laparoscopic to open based on pre-operative patient characteristics. METHODS: A retrospective review of the State Inpatient Database (2007-2011) was performed using derivation (N = 71,617) and validation (N = 143,235) cohorts of adults ≥ 18 years with acute appendicitis treated by laparoscopic-only (LA), conversion from laparoscopic to open (CA), or primary open (OA) appendectomy...
April 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28276643/single-incision-versus-conventional-three-incision-laparoscopic-appendectomy-a-meta-analysis-of-randomized-controlled-trials
#13
Li-Hui Deng, Jun-Jie Xiong, Qing Xia
BACKGROUND: Conventional three-incision laparoscopic appendectomy (CTLA) is considered the new golden standard for the treatment of acute appendicitis. However, single-incision laparoscopic appendectomy (SILA) can further reduce the number of abdominal incisions and visible scars. METHODS: Major databases were researched for randomized clinical trials (RCTs) comparing SILA and CTLA for acute appendicitis from January 1983 and to March 2015. The technical feasibility, effectiveness, and safety between SILA and CTLA were compared...
November 15, 2016: Journal of Evidence-based Medicine
https://www.readbyqxmd.com/read/28213607/efficacy-and-safety-of-nonoperative-treatment-for-acute-appendicitis-a-meta-analysis
#14
REVIEW
Roxani Georgiou, Simon Eaton, Michael P Stanton, Agostino Pierro, Nigel J Hall
CONTEXT: Nonoperative treatment (NOT) with antibiotics alone of acute uncomplicated appendicitis (AUA) in children has been proposed as an alternative to appendectomy. OBJECTIVE: To determine safety and efficacy of NOT based on current literature. DATA SOURCES: Three electronic databases. STUDY SELECTION: All articles reporting NOT for AUA in children. DATA EXTRACTION: Two reviewers independently verified study inclusion and extracted data...
March 2017: Pediatrics
https://www.readbyqxmd.com/read/28129917/patient-characteristics-outcomes-and-costs-following-interhospital-transfer-to-a-tertiary-facility-for-appendectomy-versus-patients-who-present-directly
#15
Daniel Leberer, John O Elliott, Edward Dominguez
BACKGROUND: Recent healthcare policy changes have emphasized pay-for-performance. Previous studies have not examined outcome differences between primary presenting appendicitis patients and transferred patients. METHODS: A retrospective cohort design examined appendicitis patients between March 2011 and 2013. Patients < age 18, were scheduled for an elective appendectomy, who were pregnant or had an interval appendectomy were excluded. RESULTS: The transfer cohort (n = 59) had more comorbidities, more severe American Society of Anesthesiologists status, a higher rate of pre-operative abscess/rupture as well as higher rates of perforation, gangrene, intra-operative drain placement and open conversion versus primary presenting patients (n = 622)...
January 10, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28100519/paravertebral-block-in-paediatric-abdominal-surgery-a-systematic-review-and-meta-analysis-of-randomized-trials
#16
E A Page, K L Taylor
The increased popularity of paravertebral block (PVB) can be attributed to its relative safety and comparable efficacy when compared with epidural analgesia. It has thus been recommended for open cholecystectomy and other less painful surgeries such as inguinal herniorraphy and appendectomy. We performed a systematic review of PVB in paediatric abdominal conditions to assess its clinical efficacy and side effects compared with other analgesic therapies.A search of Medline, Embase, and Web of Science and hand-searching references from inception date to May 2016 was done...
February 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28099380/predicting-appendiceal-tumors-among-patients-with-appendicitis
#17
Tyler J Loftus, Steven L Raymond, George A Sarosi, Chasen A Croft, R Stephen Smith, Philip A Efron, Frederick A Moore, Scott C Brakenridge, Alicia M Mohr, Janeen R Jordan
BACKGROUND: As nonoperative management of appendicitis gains popularity, vigilance for appendiceal tumors becomes increasingly important. We hypothesized that, among patients presenting with acute appendicitis, those with advanced age, multiple comorbidities, atypical presentation, and complicated appendicitis would be more likely to have underlying appendiceal tumors. METHODS: We performed a 4-year retrospective cohort analysis of 677 consecutive adult patients who underwent appendectomy for appendicitis at our tertiary care center...
April 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28092251/-acute-appendicitis-surgical-and-non-surgical-treatment
#18
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
#19
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
#20
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
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