scholarly journals Reasons for Undesirable Pregnancy Outcomes among Women with Appendicitis: The Experience of a Tertiary Center

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Baris Mantoglu ◽  
Fatih Altintoprak ◽  
Necattin Firat ◽  
Emre Gonullu ◽  
Enis Dikicier ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Acute Appendicitis ◽  
Preterm Delivery ◽  
Laparoscopic Appendectomy ◽  
Pregnancy Outcomes ◽  
Open Appendectomy ◽  
Multiple Pregnancy ◽  
White Blood Count ◽  
Tertiary Center ◽  
Significant Difference

Background. Although laparoscopic appendectomy increases its popularity today, the answer to the question of whether to perform open or laparoscopic appendectomy during pregnancy is appropriate in many studies, and the choice of surgery depends on the surgeon. Herein, we aimed to evaluate the variables that affect undesirable pregnancy outcomes that occur as a result of appendicitis during pregnancy. Methods. Seventy-eight pregnant patients with acute appendicitis who underwent laparoscopic or open technique intervention enrolled in this retrospective study. In addition to the demographic structure of the patients, surgical technique, the number of pregnancies, multiple pregnancy status, surgical pathologies, laboratory values, radiological imaging methods, and length of hospital stay were evaluated. The severity of appendicitis was classified according to the pathology results. The patients were divided into two groups according to the outcomes of their pregnancy. Preterm delivery and abortion involved in the study as a single complication section. Results. The mean age of the pregnant patients was 28.6 ± 5. Of the 78 pregnant women with appendicitis, 47.4% had their first pregnancy, 37.2% had their second pregnancy, and 15.4% had 3 or more pregnancies. The preterm delivery and abortus were 19.5% in the open appendectomy (OA) group and 16.2% in the laparoscopic appendectomy (LA) group. No statistically significant difference was detected in this group in terms of appendicitis pathology triggering preterm delivery or abortion (p 0.075). When white blood count (WBC) and C-reactive protein (CRP) were evaluated by laboratory findings, CRP was found to be statistically significantly higher in patients with preterm birth (p 0.042). Conclusion. Consequently, acute appendicitis may cause serious intra-abdominal infection and inflammation in addition to the complexity of the diagnosis due to the nature of pregnancy, as well as undesired pregnancy outcomes with the surgical technique, or independently with other variables.

Financial Impact of Surgical Technique in the Treatment of Acute Appendicitis in Children

2013 ◽  
Vol 79 (9) ◽  
pp. 857-860 ◽  
Author(s):  
Cristen Litz ◽  
Paul D. Danielson ◽  
Jay Gould ◽  
Nicole M. Chandler
Keyword(s):  
Surgical Technique ◽  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Single Incision ◽  
Open Appendectomy ◽  
Direct Costs ◽  
Financial Impact ◽  
Invasive Approach ◽  
Significant Difference ◽  
Supply Costs

Appendicitis is the most common emergent problem encountered by pediatric surgeons. Driven by improved cosmetic outcomes, many surgeons are offering pediatric patients single-incision laparoscopic appendectomy. We sought to investigate the financial impact of different surgical approaches to appendectomy. A retrospective study of patients with acute appendicitis undergoing appendectomy from February 2010 to September 2011 was conducted. Based on surgeon preference, patients underwent open appendectomy (OA), laparoscopic appendectomy (LA), or single-incision laparoscopic appendectomy (SILA). Demographic information, surgical outcomes, surgical supply costs, and total direct costs were recorded. A total of 465 patients underwent appendectomy during the study. The mean age of all patients was 11.2 years (range, 1 to 18 years). There were no conversions in the LA or SILA groups. There was a significant difference among surgical technique in regard to surgical supply costs (OA $159 vs LA $650 vs SILA $814, P < 0.01) and total direct costs (OA $2129 vs LA $2624 vs SILA $2991, P < 0.01). In our institution, both multiport laparoscopic and SILA carry higher costs when compared with OA, largely as a result of the cost of disposable instrumentation. Cost efficiency should be considered by surgeons when undertaking a minimally invasive approach to appendectomy.

scholarly journals Association of treatments for acute appendicitis with pregnancy outcomes in the United States from 2000 to 2016: Results from a multi-level analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0260991
Author(s):  
Jianzhou Yang ◽  
Shi Wu Wen ◽  
Daniel Krewski ◽  
Daniel J. Corsi ◽  
Mark Walker ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Pregnancy Outcomes ◽  
Preterm Labor ◽  
Open Appendectomy ◽  
The United States ◽  
Hospital Level ◽  
Multi Level ◽  
Non Surgical Treatment

Background Open appendectomy, laparoscopic appendectomy, and non-surgical treatment are three options to treat acute appendicitis during pregnancy. Previous studies on the association of different treatment methods for acute appendicitis with pregnancy outcomes have been limited by small sample sizes and residual confounding, especially with respect to hospital-level factors. This study aimed to investigate the association of treatment method for acute appendicitis with pregnancy outcomes using a multi-level analysis. Methods A retrospective cohort study was conducted based on a large electronic health records database in the United States during the period 2000 to 2016. All pregnancies diagnosed with acute appendicitis and treated in participating hospitals during the study period were included. We conducted multi-level hierarchical logistic regression to analyze both individual- and hospital-level factors for abortion, preterm labor, and cesarean section. Results A total of 10,271 acute appendicitis during pregnancy were identified during the study period. Of them, 5,872 (57.2%) were treated by laparoscopic appendectomy, 1,403 (13.7%) by open appendectomy, and 2,996 (29.2%) by non-surgical treatment. Compared with open appendectomy, both laparoscopic appendectomy (adjusted OR, 0.6, 95% CI, 0.4, 0.9) and non-surgical treatment (adjusted OR, 0.4; 95% CI, 0.3–0.7) showed a decreased risk of preterm labor. Other important individual-level determinants of adverse pregnancy outcomes included maternal age, gestational hypertension, and anemia during pregnancy, the hospital-level determinant included the number of beds. Conclusions Compared with open appendectomy, both laparoscopic appendectomy and non-surgical treatment may be associated with a lower risk of preterm labor, without increased risks of abortion and cesarean section.

scholarly journals TWO-PORT LAPAROSCOPIC APPENDECTOMY IS MORE BENEFECIAL THAN OPEN APPENDECTOMY IN EARLY ACUTE APPENDICITIS

2017 ◽  
Vol 52 (2) ◽  
pp. 131
Author(s):  
Vicky S Budipramana
Keyword(s):  
Acute Appendicitis ◽  
Wound Infection ◽  
Laparoscopic Appendectomy ◽  
Operating Time ◽  
Open Appendectomy ◽  
Operation Time ◽  
T Test ◽  
Small Incision ◽  
Post Operative Pain ◽  
Significant Difference

Open appendectomy has already commonly been performed to treat acute appendicitis, but the relatively more painful and longer incision scar becomes a cosmetical problem. Two port laparoscopic appendectomy can be performed safely, less painful and leaving only two small incision scars. The aim of the study was to evaluate the benefit of two-port laparoscopic appendectomy and that of with open appendectomy in the case of early acute appendicitis. An observational study was conducted from 2012 to 2014; to compare the operating time, post operative pain and wound infection in early acute appendicitis, performed with two-port laparoscopic appendectomy and with open appendectomy. The statistical analysis in this study uses t-test. There were 114 patients (73 men and 41 women) divided into two groups based on the choice made by the patients themselves. The number of samples performed with two-port laparoscopic appendectomy was 64 and that with open appendectomy was 46. Four patients were excluded from this study. In analysis using t-test, we found that the two-port laparoscopic appendectomy was more beneficial than open appendectomy. There was a significant difference between the two groups, the length of operation time was 37.22 minute in two-port laparoscopic appendectomy and 43.83 minute in open appendectomy (p=0.00), VAS pain score was 1.58 in two-port laparoscopic appendectomy and 2.30 in open appendectomy (p=0.00) and no post operative wound infection in both two groups. The conclusion is two-port laparoscopic appendectomy technique is faster and less painful and the same risk of wound infection than open appendectomy in early acute appendicitis.

scholarly journals Comparative study of single incision versus conventional three port laparoscopic appendectomy

2018 ◽  
Vol 5 (12) ◽  
pp. 3852 ◽  
Author(s):  
Sahil Rometra ◽  
Rahil Rometra ◽  
Neeraj Koul ◽  
R. K. Chrungoo
Keyword(s):  
Laparoscopic Surgery ◽  
Acute Appendicitis ◽  
Hospital Stay ◽  
Laparoscopic Appendectomy ◽  
Operative Time ◽  
Single Incision ◽  
Open Appendectomy ◽  
Single Incision Laparoscopic Surgery ◽  
Abdominal Incision ◽  
Significant Difference

Background: Appendicitis is primarily a disease of adolescents and young adults with a peak incidence in the second and third decades of life. Appendectomy for appendicitis is the most commonly performed emergency operation in the world.For more than a century, open appendectomy remained the gold standard for the treatment of acute appendicitis.  Laparoscopic surgery has become popular universally during the last couple of decades.   Efforts are still being made to decrease abdominal incision and visible scars after laparoscopy.  Single incision laparoscopic surgery (SILS) is a new innovation allowing minimal access surgery to be performed through a single umbilical incision.Methods: It was a prospective study carried out on 50 patients diagnosed as acute appendicitis. They were divided into two groups of 25 each. One group underwent Conventional Laparoscopic Appendectomy (CLA) and other group underwent Single Incision Laparoscopic Surgery (SILS).  Results were compared with regard to mean operative time,   complications, post-operative pain and discomfort (vas score at 12 hours), post-operative morbidity, duration of hospital stay and condition at discharge and cosmesis.Results: There was no statistically significant difference between the two groups with respect to the parameters like postoperative pain, hospital stay and complication profile. However, operative time for SILS appendectomy were found to be significantly higher compared to conventional group.Conclusions: Single incision laparoscopic appendectomy using standard laparoscopic instruments is safe and effective, feasible surgery with better cosmetic results.

Compare the Outcomes of Laparoscopic and Open Appendectomy

2021 ◽  
Vol 15 (7) ◽  
pp. 1742-1744
Author(s):  
Aqeel Ahmad ◽  
Muhammad Hammad Muzaffar ◽  
Mumtaz Ahmad Khan ◽  
Arshid Mahmood
Keyword(s):  
Acute Appendicitis ◽  
Surgical Site Infection ◽  
Hospital Stay ◽  
Laparoscopic Appendectomy ◽  
Open Appendectomy ◽  
Site Infection ◽  
Time Duration ◽  
Group I ◽  
Significant Difference ◽  
Group Ii

Aim: The aim of this study is to compare the surgical site infection, hospital stay and time duration of procedure in patients undergoing laparoscopic and open appendectomy. Study Design: Prospective/ Observational Place & Duration: Department of Surgery, Pak Red Crescent Medical and Dental college, Dina Nath, during from Jan 2020 to March 2021. Methods: In this study 240 patients of both genders with ages >10 years presented with acute appendicitis were included. Patients demographic including age, sex and body mass index were recorded after written consent. Patients were equally divided into two groups. Group I consist of 120 patients and received laparoscopic appendectomy and Group II with 120 patients received open appendectomy. Outcomes such as surgical site infection, hospital stay and time duration of procedure were examined and compare the results between both groups. Data was analyzed by SPSS 23.0. P-value <0.05 was set as significant. Results: There were 140 (58.3%) patients (70 Group I, 70 Group II) were male with mean age 25.7+6.54 years while 100 (41.7%) patients (50 Group I, 50 Group II) were females with mean age 26.9+3.12 years. No significant difference regarding BMI between both groups p=>0.05. There was a significant difference in term of surgery time duration between both groups 48.24+9.59 minutes Vs 35.74+6.86 minutes; P=0.001. No significant difference observed in term of hospital stay (p=0.345). 11 (9.2%) patients in Group II in which 5.83% had Superficial SSI and 3.7% had Deep SSI. 9 (7.5%) patients 5% superficial and 2.5% Deep SSI in Group I had developed surgical site infection with no significant difference (p=0.41). Conclusion: We concluded in this study that open appendectomy is better in term of operative time as compared to laparoscopic appendectomy. We found no significant difference regarding surgical site infection and hospital stay. Keywords: Acute appendicitis, Appendectomy, Laparoscopic, Open, Outcomes

scholarly journals Compare Laparoscopic and Open Appendectomy in Terms of Surgical Site Infection

2021 ◽  
Vol 15 (8) ◽  
pp. 2375-2377
Author(s):  
Muhammad Yousaf ◽  
Shahid Khan Afridi ◽  
Gul Sharif ◽  
Wasim Ahmad ◽  
Shoaib Muhammad ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Surgical Site Infection ◽  
Hospital Stay ◽  
Laparoscopic Appendectomy ◽  
Open Appendectomy ◽  
Site Infection ◽  
Time Duration ◽  
Group I ◽  
Significant Difference ◽  
Group Ii

Aim: The aim of this study is to compare the outcomes between laparoscopic and open appendectomy in terms of surgical site infection. Study Design: Prospective/ Observational Place & Duration: Department of Surgery, Lady Reading Hospital, Peshawar for duration of six months from January 2021 to June 2021. Methods: In this study 200 patients of both genders with ages >10 years presented with acute appendicitis were included. Patients’ demographics including age, sex and body mass index were recorded after written consent. Patients were equally divided into two groups. Group I consist of 100 patients and received laparoscopic appendectomy and Group II with 100 patients received open appendectomy. Outcomes such as surgical site infection, hospital stay and time duration of procedure were examined and compare the results between both groups. Data was analyzed by SPSS 26.0. P-value <0.05 was set as significant. Results: There were 120 (60%) patients (60 Group I, 60 Group II) were males while 80 (40%) patients (40 Group I, 40 Group II) were females. Mean age in group I was 27.9+4.45 years and in group II mean age was 28.5+4.21 years. Mean BMI in group I was 24.08+8.22 kg/m2 and in group II mean BMI was 25.03+6.17 kg/m2. There was a significant difference in term of surgery time duration between both groups 42.88+13.75 minutes Vs 33.35+9.55 minutes; P=0.003.Hospital stay was greater in group II 6.03+3.12 days as compared to group I 4.07+6.13 days. Post operatively less SSI was found among laparoscopic group 6 (6%) in which 4% had superficial SSI and 2% had deep SSI as compared to group II 12 (12%) SSI was found among in which 8% had superficial SSI and 4% had deep SSI. Conclusion: We concluded in this study that laparoscopic appendectomy is better in terms of less hospital stay with less surgical site infection as compared to open appendectomy. We found that less operative time was observed in open appendectomy as compared to laparoscopic. Keywords: Appendectomy, Outcomes, Laparoscopic, Open, Acute appendicitis

scholarly journals Predictors of Difficult Laparoscopic Appendectomy in Acute Appendicitis

2021 ◽  
Vol 17 (3) ◽  
pp. 234-240
Author(s):  
Mukesh Karki ◽  
Narayan Belbase
Keyword(s):  
Computed Tomography ◽  
Acute Appendicitis ◽  
Hospital Stay ◽  
Laparoscopic Appendectomy ◽  
Operating Time ◽  
Open Appendectomy ◽  
Duration Of Symptoms ◽  
Tertiary Center ◽  
Male Sex ◽  
Potential Factors

IntroductionAcute appendicitis is the most common surgical emergency of the abdomen and appendectomy is one of the most frequently performed surgical procedures. Laparoscopic appendectomy is one of the commonest surgical procedure in most of the tertiary center and is being an effective alternative to open appendectomy. Despite continuing evolution in laparoscopic appendectomy, this procedure continue to carry the risk of conversion to openappendectomy. The objective was to analyze the factor, identify the predictors for difficult laparoscopic appendectomy. MethodsThe study was conducted in College of Medical Sciences, Bharatpur. All patients who underwent laparoscopic appendectomy from 1st January 2020 to 30th December 2020 were included in the study after taking written informed consent. A detailed performa was developed to record informationregarding patient history, physical examination, laboratory parameters, ultrasonography findings, CT findings and intra-operative details. Laparoscopic appendectomy done in more than 120 minutes, converted into open due to difficulty in surgery and not due to complications, severe adhesions were considered to be a case of difficult appendectomy. ResultsIn our study total 94 patients underwent laparoscopic appendectomy among which 16 (17.02%) cases had difficult appendectomy. The incidence of difficult appendectomy was higher among older age group, male sex, long duration of symptoms, high white blood cell count, difficult anatomy, pre existing co-morbid condition, extreme findings on computed tomography and ultrasonography (USG). Operating time, anaesthetic time, and duration of hospital stay werelonger after difficult appendectomy.  ConclusionsIdentifying the potential factors for conversion preoperatively may assist the surgeons in making decisions concerning the management of patients with appendicitis and in the judicious use of laparoscopic appendectomy. From our study we found that independent predictors for difficult appendectomy are old age, male sex, prolonged duration of symptoms, high white blood cellcount, higher body mass index (BMI), extreme inflammation in computed tomography scan and ultrasonography. Proceeding directly with open appendectomy under these circumstances may reduce operative time, reduce hospital stay and morbidity. Keywords: Acute appendicitis, Laparoscopic appendectomy, Open appendectomy, Conversion 

scholarly journals Comparison of open versus laparoscopic appendectomy

2018 ◽  
Vol 6 (6) ◽  
pp. 2133
Author(s):  
P. S. Khatana ◽  
Jitendra Kumar ◽  
Manish Aggarwal
Keyword(s):  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Gall Stone ◽  
Operating Time ◽  
Open Appendectomy ◽  
Length Of Hospital Stay ◽  
Laparoscopic Group ◽  
Stone Disease ◽  
Significant Difference ◽  
Open Versus

Background: Although laparoscopic cholecystectomy has now considered the gold standard for the management of gall stone disease, laparoscopic appendectomy has not attained the same degree of popularity and acceptance. Aim of this study is to assess and compare the role of laparoscopic appendectomy with open appendectomy in acute appendicitis as well as in the patients planned for interval appendectomy.Methods: Total number of fifty cases over the age of 12 years were studied prospectively. Out of 50 number of total cases, 20 cases were those who have been operated laparoscopically while 30 cases were of open appendectomy group. The two groups were compared with respect to operative time, length of hospital stay, post-operative pain and nausea, complication rate and time to return to normal activity.Results: The mean age was 22.8±2(6.83) and 26.7±2(9.22) years in the laparoscopic and open groups respectively, with the range of 14 to 42 in the laparoscopic group and 13 to 50 years in the open group. The Average operating time was more in the laparoscopic appendectomy as compared to the time taken in performing open appendectomy. However, this was not statistically significant with p<0,05. Overall, there was no significant difference in the incidence of complications between open and laparoscopic groups.Conclusions: The laparoscopic appendectomy is safe, simple and efficient technique for treatment of acute appendicitis with result comparable to the open appendectomy, if not better.

scholarly journals Hospitalization time after open appendectomy by three different surgical techniques

2014 ◽  
Vol 27 (3) ◽  
pp. 188-190 ◽  
Author(s):  
Agláia Moreira Garcia XIMENES ◽  
Fernando Salvo Torres MELLO ◽  
Zailton Bezerra de LIMA-JÚNIOR ◽  
Cícero Faustino FERREIRA ◽  
Amanda Dantas Ferreira CAVALCANTI ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Acute Appendicitis ◽  
Surgical Site Infection ◽  
Open Appendectomy ◽  
Surgical Techniques ◽  
Conventional Technique ◽  
Site Infection ◽  
Hospitalization Time ◽  
Contingency Coefficient ◽  
Appendicular Stump

BACKGROUND: The choice of surgical technique to approach the appendicular stump depends mostly on skill and personal preference of the surgeon or on the protocol used in the service, and the influence of this choice in hospitalization time is not evaluated. AIM: To evaluate the relation between surgical technique and postoperative hospitalization time in patients presenting with acute appendicitis. METHODS: Retrospective analysis of 180 patients who underwent open appendectomy. These where divided into three groups according to surgical technique: conventional appendectomy (simple ligation of the stump), tobacco pouch suture and Parker-Kerr suture. Data where crossed with hospitalization time (until three days, from four to six days and over seven days). RESULTS: A hundred and eighty patients with age from 15 to 85 years where included. From these, 95 underwent conventional technique, had an average hospitalization time of 3,9 days and seven had complications (surgical site infection, seroma, suture dehiscence and evisceration). In 67 patients, tobacco pouch suture was chosen and had average hospitalization time of 3,7 days and two complications (infection and seroma). In 18 Parker-Kerr suture was made, with average hospitalization time of 2,6 days, with no complication. Contingency coefficient between the variables hospitalization time and technique was 0,255 and Cramér's V was 0,186. CONCLUSION: There was tendency to larger hospitalization time and larger number of complications in conventional appendectomy, whereas in patients where Parker-Kerr suture was performed, hospitalization time was significantly smaller.

scholarly journals Endoscopic retrograde appendicitis therapy vs. Laparoscopic appendectomy for uncomplicated acute appendicitis

Endoscopy ◽  
2022 ◽  
Author(s):  
Baohong Yang ◽  
Lingjian Kong ◽  
Ullah Saif ◽  
Lixia Zhao ◽  
Dan Liu ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Hospital Length Of Stay ◽  
Adverse Event Rate ◽  
Recurrence Time ◽  
Endoscopic Retrograde ◽  
Significant Difference ◽  
One Year ◽  
Uncomplicated Acute Appendicitis ◽  
Matching Criteria

Background and study aims: To assess the efficacy and clinical outcomes of endoscopic retrograde appendicitis therapy (ERAT) versus laparoscopic appendectomy (LA) for patients with uncomplicated acute appendicitis (AA). Patients and methods: We adopted propensity score matching (1:1) to compare ERAT and LA patients with uncomplicated AA from April 2017 to March 2020. We reviewed a total of 2880 patients with suspected acute appendicitis, of whom 422 patients with uncomplicated AA met the matching criteria (ERAT, 79; LA, 343), yielding 78 pairs of patients. Results: The rate of curative treatment within one year after ERAT was 92.1%; 95% CI, [83.8% - 96.3%]. The percentage of Visual Analog Scale (VAS) ≤ 3 at six hours after treatment was 94.7%; 95% CI [87.2% - 97.9%] in the ERAT group, and significantly higher than that in the LA group 83.3%; 95% CI [73.5% - 90.0%]. Median operative/procedure time and median hospital length of stay in the ERAT group were significantly lower compared to the LA group. At one year, the median recurrence time was 50 days (IQRs, 25-127) in the ERAT group. The overall adverse event rate was 24.3%; 95% CI [14.8% - 33.9%] in the LA group and 18.4%; 95% CI [9.7% - 27.1%] in the ERAT group, with no significant difference between the two groups. Conclusions: ERAT is a technically feasible method to treat uncomplicated AA compared to LA.

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