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Interval appendectomy

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
James A Meltzer, Sergey Kunkov, Jennifer H Chao, Ee Tein Tay, Jerry P George, David Borukhov, Stephen Alerhand, Prince A Harrison, Jeffrey Hom, Ellen F Crain
OBJECTIVE: The aim of this study was to assess whether increased time from emergency department (ED) triage to appendectomy is associated with a greater risk of children developing appendiceal perforation. METHODS: We performed a multicenter retrospective cohort study of children younger than 18 years hospitalized with appendicitis. To avoid enrolling patients who had perforated prior to ED arrival, we included only children who had a computed tomography (CT) scan demonstrating nonperforated appendicitis...
September 30, 2016: Pediatric Emergency Care
L Segev, Y Segev, S Rayman, A Nissan, E Sadot
BACKGROUND: Acute appendicitis is the most common nonobstetric indication for surgical intervention during pregnancy. However, the current literature is scarce and composed of relatively small case series. We aimed to compare the presentation, management, and surgical outcomes of presumed acute appendicitis between a contemporary cohort of pregnant women and nonpregnant women of reproductive age. METHODS: The study group included 92 pregnant patients who underwent appendectomy for presumed acute appendicitis at a single tertiary medical center in 2000-2014...
October 11, 2016: World Journal of Surgery
Jea Yeon Choi, Eell Ryoo, Jeong Hyun Jo, Tchah Hann, Seong Min Kim
PURPOSE: This study examined the risk factors of a delayed diagnosis of acute appendicitis in children undergoing an appendectomy. METHODS: This retrospective study involved children aged below 18 years, who underwent an appendectomy. After dividing them into a delayed diagnosis group and nondelayed diagnosis group according to the time interval between the initial hospital visit and final diagnosis, the risk factors of delayed diagnosis were identified using logistic regression analysis...
September 2016: Korean Journal of Pediatrics
Keisuke Jimbo, Masahiro Takeda, Eri Miyata, Hiroshi Murakami, Reiko Kyodo, Hideki Orikasa, Geoffrey J Lane, Toshiaki Shimizu, Atsuyuki Yamataka
PURPOSE: The purpose of this study was to examine whether acute non-perforated appendicitis (ANPA) can be safely triaged by a pediatrician for conservative management (CM) using gray-scale ultrasonography with power Doppler (GSPD). METHOD: Seventy five cases of ANPA assessed by a pediatrician with GSPD (2013-2015) were reviewed. GSPD grading for ANPA was: I: slightly irregular wall/normal blood flow; II: irregular wall/increased blood flow; III: irregular wall/decreased blood flow; and IV: absence of wall/blood flow...
September 15, 2016: Journal of Pediatric Surgery
Yujiro Tanaka, Hiroo Uchida, Hiroshi Kawashima, Michimasa Fujiogi, Keisuke Suzuki, Shinya Takazawa, Kyoichi Deie, Hizuru Amano, Tadashi Iwanaka
BACKGROUND: Although nonoperative treatment (non-OPT) for complicated appendicitis is performed widely, the long-term outcomes and merits of interval appendectomy (IA) need to be evaluated. METHODS: Between April 2007 and December 2013, all appendicitis patients with well-circumscribed abscess or phlegmon were required to select either laparoscopic surgery (OPT) or non-OPT with optional IA on admission. Optional IA was planned at ≥3months after non-OPT. For non-OPT, intravenous injection of antibiotics was continued until the serum C-reactive protein concentration decreased to <0...
September 15, 2016: Journal of Pediatric Surgery
Elisabeth Svensson, Erzsébet Horváth-Puhó, Morten Gersel Stokholm, Henrik Toft Sørensen, Victor W Henderson, Per Borghammer
OBJECTIVES: The appendix may be a key site for the initiation of Parkinson's disease (PD) pathology. We examined the hypothesis that appendectomy is associated with lower PD risk. METHODS: We used Danish medical and administrative registries to construct a cohort of all patients in Denmark with an operation code of appendectomy during 1980-2010 (n = 265,758) and a matched general population comparison cohort (n = 1,328,790). Using Cox regression, we computed hazard ratios and corresponding 95% confidence intervals for PD, adjusting for potential confounders and stratifying on age at appendectomy (≤45 years / > 45 years), sex, and follow-up time...
September 13, 2016: Movement Disorders: Official Journal of the Movement Disorder Society
Frederick Thurston Drake, Neli E Mottey, Anthony A Castelli, Michael G Florence, Morris G Johnson, Scott R Steele, Richard C Thirlby, David R Flum
BACKGROUND: Observational research has shown that delayed presentation is associated with perforation in appendicitis. Many factors that affect the ability to present for evaluation are influenced by time of day (eg, child care, work, transportation, and office hours of primary care settings). Our objective was to evaluate for an association between care processes or clinical outcomes and presentation time of day. METHODS: The study evaluated a prospective cohort of 7,548 adults undergoing appendectomy at 56 hospitals across Washington State...
August 31, 2016: Surgery
Oğuzhan Özdemir, Yavuz Metin, Nurgül Orhan Metin, Ali Küpeli, Süleyman Kalcan, Filiz Taşçı
OBJECTIVE: We aimed to search the contribution of diffusion-weighted imaging (DWI) in follow-up of patients with acute appendicitis associated inflammatory appendiceal mass (IAM). DWI was used as a monitoring imaging method to assess the response of medical treatment. MATERIALS AND METHODS: 19 patients (mean age, 37+-13.1; age range, 19-69; M/F: 10/9), presented with clinical, laboratory and computed tomography (CT) findings suggestive of IAM were enrolled prospectively in this study...
2016: European Journal of Radiology Open
James K Hamill, Andrew Liley, Andrew G Hill
OBJECTIVE: The aim of this study was to investigate the efficacy of intraperitoneal local anesthetic (IPLA) on pain after acute laparoscopic appendectomy in children. SUMMARY OF BACKGROUND: IPLA reduces pain in adult elective surgery. It has not been well studied in acute peritoneal inflammatory conditions. We hypothesized that IPLA would improve recovery in pediatric acute laparoscopic appendectomy. METHODS: This randomized controlled trial in acute laparoscopic appendectomy recruited children aged 8 to 14 years to receive 20 mL 0...
August 17, 2016: Annals of Surgery
Dani O Gonzalez, Katherine J Deans, Peter C Minneci
Appendectomy is currently considered the standard of care for children with acute appendicitis. Although commonly performed and considered a safe procedure, appendectomy is not without complications. Non-operative management has a role in the treatment of both uncomplicated and complicated appendicitis. In uncomplicated appendicitis, initial non-operative management appears to be safe, with an approximate 1-year success rate of 75%. Compared to surgery, non-operative management is associated with less disability and lower costs, with no increase in the rate of complicated appendicitis...
August 2016: Seminars in Pediatric Surgery
Lara Senekjian, Raminder Nirula, Brandon Bellows, Richard Nelson
BACKGROUND: Patients with phlegmonous appendicitis can be managed nonoperatively, yet debate continues about the need for interval appendectomy (IA), given the low risk of recurrence or neoplasm. We sought to determine for which patient age interval appendectomy is cost-effective. METHODS: Using TreeAge software, a cost-effectiveness model was developed. Two strategies were compared, IA and no interval appendectomy (NIA). Interval appendectomy patients were modeled with probability of benign pathology, cancer or inflammatory bowel disease, and possible operative complications...
October 2016: Journal of the American College of Surgeons
Maru Kim, Sung Jeep Kim, Hang Joo Cho
PURPOSE: This study was aimed to evaluate the effect of time of surgery for acute appendicitis on surgical outcomes to optimize the timing of appendectomies. METHODS: Medical records of patients who underwent an appendectomy were reviewed to obtain data on time of symptom onset, time of hospital presentation, and start times of surgery. Surgical findings were used to define appendicitis as either uncomplicated or complicated. The uncomplicated group included patients with simple, focal, or suppurative appendicitis, and the complicated group included patients with gangrenous, perforated appendicitis or periappendiceal abscess formation...
August 2016: Annals of Surgical Treatment and Research
Kee-Hwan Kim, Sang Chul Lee, Sang Kuon Lee, Byung-Jo Choi, Wonjun Jeong, Say-June Kim
PURPOSE: As several years have passed since the implementation of the Korean diagnosis-related group (DRG) payment system for appendicitis, its early outcomes should be assessed to determine if further improvements are warranted. METHODS: We retrospectively analyzed clinical data from Korean patients who underwent appendectomy, dividing the sample into 2 groups of those who received services before and after implementation of the DRG system. Based on the DRG code classification, patient data were collected including the amount of DRG reimbursement and the total in-patient costs...
August 2016: Annals of Surgical Treatment and Research
Sung Uk Bae, Woon Kyung Jeong, Seong Kyu Baek
PURPOSE: Nonoperative management followed by an interval appendectomy is a commonly used approach for treating patients with perforated appendicitis with abscess formation. As minimally-invasive surgery has developed, single-port laparoscopic surgery (SPLS) is increasingly being used to treat many conditions. We report our initial experience with this procedure using a multichannel single-port. METHODS: The study included 25 adults who underwent a single-port laparoscopic interval appendectomy for perforated appendicitis with periappendiceal abscess by using a single-port with or without needlescopic grasper between June 2014 and January 2016...
June 2016: Annals of Coloproctology
Ik Yong Kim
No abstract text is available yet for this article.
June 2016: Annals of Coloproctology
Shawn J Rangel, Brett R Anderson, Rajendu Srivastava, Samir S Shah, Paul Ishimine, Mythili Srinivasan, Matthew Bryan, Wu Gong, Matt Hall, Russell Localio, Xianqun Luan, Seema Anandalwar, Ron Keren
OBJECTIVE: To compare treatment failure leading to hospital readmission in children with complicated appendicitis who received oral versus intravenous antibiotics after discharge. BACKGROUND: Antibiotics are often employed after discharge to prevent treatment failure in children with complicated appendicitis, although existing studies comparing intravenous and oral antibiotics for this purpose are limited. METHODS: We identified all patients aged 3 to 18 years undergoing appendectomy for complicated appendicitis, who received postdischarge antibiotics at 35 childrens hospitals from 2009 to 2012...
July 15, 2016: Annals of Surgery
Li Wei, Thomas MacDonald, Sami Shimi
OBJECTIVE: To study pregnancy rates after appendectomy and/or tonsillectomy. DESIGN: Population-based cohort study using the United Kingdom (U.K.) primary health care-based Clinical Practice Research Datalink (CPRD). SETTING: Not applicable. PATIENT(S): Female patients who underwent appendectomy, tonsillectomy, or both from 1987 to 2012 and appropriate comparators. INTERVENTION(S): Timed follow-up until first pregnancy after surgery...
July 6, 2016: Fertility and Sterility
Kuan-Fu Liao, Shih-Wei Lai, Cheng-Li Lin, Sou-Hsin Chien
Little is known on the association between appendectomy and pyogenic liver abscess. The objective of this study was to investigate the association between appendectomy and the risk of pyogenic liver abscess in Taiwan.This population-based retrospective cohort study was conducted using the hospitalization dataset of the Taiwan National Health Insurance Program. There were 212,530 subjects age 20 to 84 years with newly diagnosed appendectomy as the appendectomy group since 1998 to 2010, and 850,099 randomly selected subjects without appendectomy as the nonappendectomy group...
June 2016: Medicine (Baltimore)
Matthew P Kronman, Assaf P Oron, Rachael K Ross, Adam L Hersh, Jason G Newland, Adam Goldin, Shawn J Rangel, Scott J Weissman, Danielle M Zerr, Jeffrey S Gerber
BACKGROUND AND OBJECTIVES: Appendicitis guidelines recommend either narrower- or extended-spectrum antibiotics for treatment of complicated appendicitis. The goal of this study was to compare the effectiveness of extended-spectrum versus narrower-spectrum antibiotics for children with appendicitis. METHODS: We performed a retrospective cohort study of children aged 3 to 18 years discharged between 2011 and 2013 from 23 freestanding children's hospitals with an appendicitis diagnosis and appendectomy performed...
July 2016: Pediatrics
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