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Interval appendectomy

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https://www.readbyqxmd.com/read/28421569/two-step-procedure-for-complicated-appendicitis-with-perityphlitic-abscess-formation
#1
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
#2
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...
April 14, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28387683/appendectomy-history-is-not-related-to-parkinson-s-disease
#3
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
#4
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...
March 16, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28288060/the-global-incidence-of-appendicitis-a-systematic-review-of-population-based-studies
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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 2017: Seminars in Reproductive Medicine
https://www.readbyqxmd.com/read/28039865/sonographic-differentiation-of-complicated-from-uncomplicated-appendicitis-implications-for-antibiotics-first-therapy
#17
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
#18
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
#19
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
#20
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...
May 2017: Surgery
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