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Interval appendectomy

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https://www.readbyqxmd.com/read/29431586/drain-failure-in-intra-abdominal-abscesses-associated-with-appendicitis
#1
Christopher B Horn, Adrian A Coleoglou Centeno, Jarot J Guerra, John E Mazuski, Grant V Bochicchio, Isaiah R Turnbull
BACKGROUND: Previous studies have suggested that percutaneous drainage and interval appendectomy is an effective treatment for appendicitis with associated abscess. Few studies to date have analyzed risk factors for failed drain management. We hypothesized that older patients with more co-morbidities would be at higher risk for failing conservative treatment. METHODS: The 2010-2014 editions of the National Inpatient Sample (NIS) were queried for patients with diagnoses of peri-appendiceal abscesses...
February 12, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29370051/a-protocol-for-non-operative-management-of-uncomplicated-appendicitis
#2
Tyler J Loftus, Camille G Dessaigne, Chasen A Croft, R Stephen Smith, Philip A Efron, Frederick A Moore, Scott C Brakenridge, Alicia M Mohr, Janeen R Jordan
BACKGROUND: We developed a protocol to identify candidates for non-operative management (NOM) of uncomplicated appendicitis. Our objective was to evaluate protocol efficacy with the null hypothesis that clinical outcomes, hospital readmission rates, and hospital charges would be unchanged after protocol implementation. METHODS: We performed a single-center 4-year propensity score matched retrospective cohort analysis of 406 patients with acute uncomplicated appendicitis...
February 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29353527/irrigation-versus-suction-alone-in-laparoscopic-appendectomy-is-dilution-the-solution-to-pollution-a-systematic-review-and-meta-analysis
#3
Shahab Hajibandeh, Shahin Hajibandeh, Adam Kelly, Jigar Shah, Rao Muhammad Asaf Khan, Nilanjan Panda, Moustafa Mansour, Sohail Malik, Sanjay Dalmia
OBJECTIVES: To investigate outcomes of peritoneal irrigation versus suction without irrigation in patients undergoing emergency laparoscopic appendectomy. METHODS: We performed a systematic review and conducted a search of electronic information sources to identify all randomized controlled trials (RCTs) and observational studies investigating outcomes of irrigation versus suction alone in patients undergoing emergency laparoscopic appendectomy. We used the Cochrane risk of bias tool and the Newcastle-Ottawa scale to assess the risk of bias of RCTs and observational studies, respectively...
January 1, 2018: Surgical Innovation
https://www.readbyqxmd.com/read/29352339/effect-of-time-to-operation-on-value-of-care-in-acute-care-surgery
#4
Tyler J Loftus, Martin D Rosenthal, Chasen A Croft, R Stephen Smith, Philip A Efron, Frederick A Moore, Alicia M Mohr, Scott C Brakenridge
BACKGROUND: As reimbursement models evolve, there is increasing emphasis on maximizing value-based care for inpatient conditions. We hypothesized that longer intervals between admission and surgery would be associated with worse outcomes and increased costs for acute care surgery patients, and that these associations would be strongest among patients with high-risk conditions. METHODS: We performed a 5-year retrospective analysis of three risk cohorts: appendectomy (low-risk for morbidity and mortality, n = 618), urgent hernia repair (intermediate-risk, n = 80), and laparotomy for intra-abdominal sepsis with temporary abdominal closure (sTAC; high-risk, n = 102)...
January 19, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29337180/impact-of-an-acute-surgical-unit-in-appendicectomy-outcomes-a-systematic-review-and-meta-analysis
#5
REVIEW
Ishwarya Balasubramanian, Ben Creavin, Des Winter
BACKGROUND: The provision of emergency general surgical services is undergoing a paradigm shift towards a consultant led, patient centered model in order to improve patient outcomes. The aim of this current study is to use meta-analytical techniques to assess the efficacy of acute surgical unit (ASU) in appendectomy. METHODS: A meta-analysis was conducted according to the PRISMA guidelines. A comprehensive literature search of PubMed, Embase and Scopus for published studies comparing ASU and traditional (TRAD) model on appendectomy outcomes was performed...
January 11, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29336758/occult-appendiceal-neoplasms-in-acute-and-chronic-appendicitis-a-single-institution-experience-of-1793-appendectomies
#6
Jamie A Schwartz, Craig Forleiter, David Lee, Grace J Kim
The incidence of appendiceal neoplasms may have been underreported in the past. Patients undergoing incidental appendectomies or appendectomies for chronic appendicitis may be at higher risk for an incidental appendiceal neoplasm. To determine the incidence of occult appendiceal neoplasms and identify risk factors associated with this pathology, a retrospective review of a pathology specimen database was conducted from November 2007 to December 2011, in a single tertiary care hospital center. All patients with appendectomies were included for analysis (n = 1793)...
December 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29334144/acute-gastrointestinal-bleeding-from-appendiceal-diverticulitis-diagnosed-preoperatively-by-combined-short-interval-computed-tomography-and-colonoscopy-a-case-report
#7
Yutaro Ogawa, Naoki Asayama, Shinji Nagata
Colonic diverticular bleeding is the most common cause of lower gastrointestinal bleeding1,2 . Appendiceal diverticulosis is an uncommon clinical entity, with an incidence of 0.004%-2% in surgical pathologic specimens3,4 . Appendiceal diverticulitis in symptomatic patients should be treated with early resection, because of the risk of perforation and peritonitis; the rate of perforation is higher in appendicitis (27%) with diverticulosis than in appendicitis alone (6.6%)5 . Untreated appendiceal diverticulitis can also lead to massive gastrointestinal hemorrhage and abscess formation, and has a potential role in the development of pseudomyxoma peritonei...
January 15, 2018: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/29285140/bayesian-network-meta-analysis-of-the-effects-of-single-incision-laparoscopic-surgery-conventional-laparoscopic-appendectomy-and-open-appendectomy-for-the-treatment-of-acute-appendicitis
#8
Jian Feng, Naiqiang Cui, Zhenyu Wang, Jutao Duan
The present study aimed to systematically evaluate the effectiveness of single-incision laparoscopic surgery (SILS), conventional laparoscopic appendectomy (CLA) and open appendectomy (OA) for the treatment of acute appendicitis. PubMed and Embase databases were systematically searched to identify relevant studies comparing the effectiveness of different appendectomy methods for treating acute appendicitis published prior to April 2016. ADDIS 1.16.5 software was used for data analysis. Heterogeneity was assessed using I2 statistic...
December 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29223668/transumbilical-extracorporeal-laparoscopic-assisted-appendectomy
#9
Lindsey Perea, William H Peranteau, Pablo Laje
AIM OF THE STUDY: The perfect balance between safety, cosmesis, and cost effectiveness in a world with ever growing healthcare costs has yet to be found for nonperforated appendicitis. The aim is to present our data regarding safety and cost effectiveness of the transumbilical extracorporeal laparoscopic-assisted appendectomy technique. METHODS: A retrospective review was performed for all laparoscopic appendectomies for acute appendicitis from October 2014 to October 2016...
November 13, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29200067/randomized-clinical-trial-of-preoperative-high-dose-methylprednisolone-on-postoperative-pain-at-rest-after-laparoscopic-appendectomy
#10
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
#11
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
#12
COMPARATIVE STUDY
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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