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laparoscopic appendectomy

Derek B Wall, Carlos Ortega
BACKGROUND: Even in metropolitan areas, on-call pediatric surgeons may not always be immediately available for surgical care of appendicitis, potentially leading to delays in care. In 2012, the in-house trauma group at a suburban Level 1 trauma center (none with formal pediatric fellowship training) assumed surgical care of 5-10 year-old children with appendicitis, who had previously been cared for by pediatric surgeons. We propose to compare the outcomes of the trauma and pediatric surgery groups...
March 16, 2018: Journal of Trauma and Acute Care Surgery
Martin Dübbers, Elena Nikolaou, Hans Fuchs, Janina Fischer, Hakan Alakus, Jessica Leers, Christiane Bruns, Grigore Cernaianu
BACKGROUND: Transumbilical laparoscopic-assisted appendectomy (TULAA) is fast and cost-effective since no endoloops, staplers or wound protection devices are used. We analyzed the effects of TULAA as first approach for perforated (PA) and non-perforated (NPA) appendicitis in children. PATIENTS: We performed a retrospective analysis of 181 children for whom TULAA was the first approach for appendicitis between October 2010 and March 2016. METHODS: Morbidity, additional laparoscopic instrument insertion (AI), conversions to open extraumbilical appendectomy (OC), and complications were evaluated...
March 15, 2018: Klinische Pädiatrie
M D Bolmers, C C van Rossem, R R Gorter, W A Bemelman, A A W van Geloven, H A Heij
PURPOSE: A laparoscopic approach for emergency appendectomy is increasingly used, in pediatric patients as well. The objective of this study is to audit the current state of diagnostic work-up, surgical techniques and its outcome in children with acute appendicitis. METHODS: A prospective consecutive observational cohort study was carried out in a 2-month study period. All patients under 18 years that were operated for suspected acute appendicitis were included...
March 9, 2018: Pediatric Surgery International
Tishara Wijayanayaka, Jacob Davidson, Andreana Bütter
PURPOSE: The purpose of this study was to determine whether children with a positive ultrasound (US) for acute appendicitis but a negative clinical picture developed appendicitis requiring definitive management. METHODS: After obtaining IRB approval, we conducted a retrospective review of patients ≤17years who presented with possible acute appendicitis between April 1st, 2014, and December 31st, 2015. We included patients with a US suggestive of acute appendicitis based on size criteria but without concerning clinical features...
February 9, 2018: Journal of Pediatric Surgery
Laurent G Glance, Richard P Dutton, Changyong Feng, Yue Li, Stewart J Lustik, Andrew W Dick
BACKGROUND: Under the Merit-based Incentive Payment System, physician payment will be adjusted using a composite performance score that has 4 components, one of which is resource use. The objective of this exploratory study is to quantify the facility-level variation in surgical case duration for common surgeries to examine the feasibility of using surgical case duration as a performance metric. METHODS: We used data from the National Anesthesia Clinical Outcomes Registry on 404,987 adult patients undergoing one of 6 general surgical or orthopedic procedures: laparoscopic appendectomy, laparoscopic cholecystectomy, laparoscopic cholecystectomy with intraoperative cholangiogram, knee arthroscopy, laminectomy, and total hip replacement...
March 6, 2018: Anesthesia and Analgesia
Kristin Gee, Sandra Ngo, Lorrie Burkhalter, Alana L Beres
BACKGROUND: Appendicitis is the most common gastrointestinal pediatric surgical emergency. With the introduction of laparoscopic techniques in the 1990s, recovery, pain, and hospital stay after laparoscopic procedures have been significantly reduced. While many laparoscopic procedures are performed as outpatient surgeries, pediatric appendectomy patients continue to be hospitalized for postoperative observation. Our goal was to evaluate the safety and feasibility of same day discharge after laparoscopic appendectomy for uncomplicated appendicitis...
February 9, 2018: Journal of Pediatric Surgery
Alejandro Ruiz-Patiño, Samuel Rey, German Molina, Luis Carlos Dominguez, Saul Rugeles
BACKGROUND: Colombia is a developing nation in need for efficient resource administration in fields such as health care, where innovation is constant. Since the introduction of laparoscopic appendectomy (LA), direct costs have been increasing without definitive results in terms of clinical outcomes. The objective of this study is to determine the cost-effectiveness of open appendectomy (OA) versus LA and thereby help surgeons in clinical decision-making in a limited resource setting. METHODS: A retrospective cost-effectiveness analysis comparing OA versus multiport LA during 2013 in a third-level university hospital (Hospital Universitario San Ignacio) in Bogota, Colombia was performed...
April 2018: Journal of Surgical Research
Gayathri Naganathan, Nalin Kumar Amin
INTRODUCTION: Raoultella Planticola is a gram negative, aerobic, rod bacteria found in water and soil and is rarely reported to cause infections in humans. This case study is the first of its kind in reporting R. planticola appendicitis. PRESENTATION OF CASE: We report a case of a woman presenting with a two-day history of increased weakness, fatigue and anorexia, localized pain to the right lower quadrant, and elevated white blood cell count. CT results demonstrated acute uncomplicated appendicitis which was managed via laparoscopic appendectomy...
February 9, 2018: International Journal of Surgery Case Reports
S A Sovtsov, A G Kriger, O V Pribytkova, A V Smirnov
AIM: To study the possibility of antibacterial therapy for acute appendicitis as an alternative to surgical treatment. MATERIAL AND METHODS: For the period 1985-2010 diagnostic laparoscopy was performed in 5548 patients with suspected acute appendicitis. Acute phlegmonous or gangrenous appendicitis was observed in 2275 (41.0%) patients who underwent laparoscopic appendectomy. Other acute diseases occurred in 2458 (44.3%) patients. Acute catarrhal appendicitis or secondary inflammation of the appendix were diagnosed in 815 (14...
2018: Khirurgiia
Belén Aneiros Castro, Indalecio Cano Novillo, Araceli García Vázquez, Pedro Yuste García, Eduardo Ferrero Herrero, Andrés Gómez Fraile
INTRODUCTION: Subhepatic appendicitis in children is an unusual condition that can be challenging for the pediatric surgeons to treat. The aim of our study was to compare the outcomes of laparoscopic appendectomies based on the position of the appendix. METHODS: The data of 1736 patients who had undergone laparoscopic appendectomy in our tertiary center were retrospectively reviewed. We compared two groups: subhepatic location (n = 56) and non-subhepatic location (n = 1680)...
February 19, 2018: Asian Journal of Endoscopic Surgery
Vishwanath M Pattanshetti, Kanyadhara L Krishna
INTRODUCTION: Management of appendicitis has evolved dramatically in the last 120 years, from McBurney's large incision to minimally invasive laparoscopic appendectomy to hardly noticeable incisions with SILS. As a bridge between conventional laparoscopic surgery and SILS, double-incision laparoscopic surgery further minimizes the invasiveness of laparoscopic surgery by reducing the number of incisions. This study aimed to establish the efficacy of double-incision, three-port laparoscopic appendectomy (DILA) as an alternative to conventional three-port laparoscopic appendectomy...
February 19, 2018: Asian Journal of Endoscopic Surgery
Michael J Nooromid, Eddie Blay, Jane L Holl, Karl Y Bilimoria, Julie K Johnson, Mark K Eskandari, Jonah J Stulberg
Introduction: Recent literature has shown a wide variation in the prescribing patterns of opioids after elective surgery. We conducted an evaluation of discharge opioid prescribing after elective surgical procedures to determine whether opioid-prescribing patterns varied at our institution. Method: A single academic medical center retrospective review of patients undergoing laparoscopic cholecystectomy, laparoscopic appendectomy, open umbilical hernia repair, simple mastectomy, or thyroidectomy between July 2015 and July 2016...
January 2018: Pain Reports (Baltimore, Md.)
Andrea Pakula, Ruby Skinner
INTRODUCTION: Acute care surgeons care for the entire breadth of the American adult population, including obese patients. As the population gets heavier, more patients will present to acute case surgeons with nonbariatric surgical emergencies. Do these surgeons need bariatric training to properly care for obese population? OBJECTIVES: To evaluate our experience in obese population requiring acute surgery and compare outcomes based on surgeon expertise in bariatric surgery...
December 14, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Maria Escolino, Francois Becmeur, Amulya Saxena, Holger Till, George W Holcomb, Ciro Esposito
BACKGROUND: There is a limited and conflicting evidence about the most appropriate method for appendiceal stump closure during laparoscopic appendectomy (LA). We aimed to compare endoloop (EL) versus endostapler (ES) for stump closure during LA for complicated perforated appendicitis in children. METHODS: We retrospectively reviewed the records of 708 patients (463 boys and 245 girls with an average age of 9.8 years) who underwent LA for complicated appendicitis in 5 international centers of Pediatric Surgery over a 5-years period (January 2011-December 2016)...
February 5, 2018: Surgical Endoscopy
Benjamin T Jarman, Colette T O'Heron, Kara J Kallies, Thomas H Cogbill
OBJECTIVE: Providing opportunities for autonomy to enhance the development of independence and confidence during surgery residency remains among the greatest challenges of the current training paradigm. The objective of this study was to evaluate the implementation and outcomes of a chief resident service (CRS). DESIGN: A CRS was designed with operative, call and office responsibilities. Supervision and evaluation were consistent with institutional guidelines. CRS operative logs from 2011 to 2014 were compared with logs from the participants' first year in practice...
February 2, 2018: Journal of Surgical Education
Giuseppe Carbotta, Antonella Del Vecchio, Antonio Prestera, Rita Laforgia, Maria Grazia Sederino, Giovanni Casamassima, Marina Minafra, Salvatore Fedele, Giovanni Balducci, Nicola Palasciano
AIM: The aim of our study is to compare the pre, intra- and post-operative variables of the two surgical techniques, to demonstrate if laparoscopic appendectomy can be considered safer and associated to better outcome. MATERIAL OF STUDY: A retrospective analysis of 175 patients has been carried out. Alvarado score, time of surgery, analgesic therapy and length of hospital stay calculated. Finally, postoperative complications were recorded. RESULTS: From January 2011 - April 2016 175 patients were enrolled: 128pts underwent laparoscopic technique and 47pts open technique...
January 31, 2018: Annali Italiani di Chirurgia
Anaar Siletz, Jonathan Grotts, Catherine Lewis, Areti Tillou, Henry Magill Cryer, Ali Cheaito
The objective of this study was to evaluate usage and outcomes of emergency laparoscopic versus open surgery at a single tertiary academic center. Over a three-year period 165 patients were identified retrospectively using National Surgical Quality Improvement Program results. Appendectomies and cholecystectomies were excluded. Open and laparoscopic approaches were compared regarding preoperative and operative characteristics, the development of postoperative complications, 30-day mortality, and length of hospital stay...
October 1, 2017: American Surgeon
Sara Schülin, Nadine Schlichting, Carlotta Blod, Sabine Opitz, Anne Suttkus, Catalina Suzana Stingu, Kathryn Barry, Martin Lacher, Ulf Bühligen, Steffi Mayer
Intestinal microbiota is involved in metabolic processes and the pathophysiology of various gastrointestinal disorders. We aimed to characterize the microbiome of the appendix in acute pediatric appendicitis comparing extraluminal and intraluminal samples.Between January and June 2015, 29 children (3-17 years, mean age 10.7 ± 3.4 years, sex M:F = 2.6:1) undergoing laparoscopic appendectomy for acute appendicitis were prospectively included in the study. Samples for bacterial cultures (n = 29) and 16S ribosomal desoxyribonucleic acid (rDNA) sequencing (randomly chosen n = 16/29) were taken intracorporeally from the appendiceal surface before preparation ("extraluminal") and from the appendiceal lumen after removal ("intraluminal")...
December 2017: Medicine (Baltimore)
A Binet, K Braïk, F Lengelle, M Laffon, H Lardy, S Amar
BACKGROUND: Appendectomy is a well-established surgical procedure in pediatric surgery used in the management of acute appendicitis. With the continuous advancement in the field of minimal invasive surgery, the recent focus is on single incision laparoscopic (SIL) surgery. SILA also goes further in order to decrease pain, improve recovery and enhance patient satisfaction. However, this approach is still not a well-established technique and not widely practiced, especially in pediatric surgery...
December 27, 2017: Journal of Pediatric Surgery
Andrew P Loehrer, David C Chang, John W Scott, Matthew M Hutter, Virendra I Patel, Jeffrey E Lee, Benjamin D Sommers
Importance: Lack of insurance coverage has been associated with delays in seeking care, more complicated diseases at the time of diagnosis, and decreased likelihood of receiving optimal surgical care. The Patient Protection and Affordable Care Act's (ACA) Medicaid expansion has increased coverage among millions of low-income Americans, but its effect on care for common surgical conditions remains unknown. Objective: To evaluate the association of the ACA's Medicaid expansion with access to timely and recommended care for common and serious surgical conditions...
January 24, 2018: JAMA Surgery
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