scholarly journals Analysis of 190 Female Patients after Appendectomy

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Abdulrahman M. Alotaibi ◽  
Leena H. Moshref ◽  
Rana H. Moshref ◽  
Lina S. Felemban
Keyword(s):  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Preterm Labor ◽  
Retrospective Cohort ◽  
Complicated Appendicitis ◽  
E Coli ◽  
Female Patients ◽  
Tertiary Center ◽  
Ultrasound Investigation ◽  
Fluid Culture

This study is a retrospective cohort review carried out at a single, private tertiary center. We included 190 female patients who underwent surgery for acute appendicitis between January 2016 and December 2018. Two groups of patients were analyzed based on the pregnancy. The main outcome measures were complication rate and risk of abortion during or after surgery. Out of 190 female patients, eight of them were pregnant (4.2%). The pregnant group more significantly underwent ultrasound investigation compared to the nonpregnant group. Complicated appendicitis present in two pregnant patients at advanced gestational age was not statistically significant from nonpregnant. Laparoscopic appendectomy was performed in 6/8 (75%) of pregnant compared to 158/182 (87%) in nonpregnant ( p  = 0.415). Compared to the nonpregnant, the pregnant group has a more fecolith, positive peritoneal fluid culture, and wound infection, with E. coli more frequently isolated in 25%. None of the pregnant patients had an abortion, preterm labor, or mortality during or after surgery. In conclusion, laparoscopic appendectomy is a low-risk operation for pregnant with acute appendicitis.

Laparoscopic Appendectomy: Differences between Male and Female Patients with Suspected Acute Appendicitis

2007 ◽  
Vol 31 (2) ◽  
pp. 409-413 ◽  
Author(s):  
George Tzovaras ◽  
Paraskevi Liakou ◽  
Ioannis Baloyiannis ◽  
Michael Spyridakis ◽  
Fotios Mantzos ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Male And Female ◽  
Female Patients ◽  
Suspected Acute Appendicitis

scholarly journals Milyen hatása van a COVID–19-járványnak a gyermekkori akut appendicitisekre?

2021 ◽  
Vol 162 (16) ◽  
pp. 608-610
Author(s):  
Balázs Fadgyas ◽  
Gábor István Garai ◽  
Zoltán Ringwald
Keyword(s):  
Statistical Analysis ◽  
Acute Appendicitis ◽  
Antibiotic Treatment ◽  
Laparoscopic Appendectomy ◽  
Perforated Appendicitis ◽  
Complicated Appendicitis ◽  
Histological Findings ◽  
Exact Test ◽  
Fisher's Exact Test ◽  
Fisher’S Exact Test

Összefoglaló. Bevezetés: A COVID–19-pandémia miatt a gyermekkori appendicitisek kezelésében számos változás történt (laparoszkópia helyett nyílt műtét, antibiotikumkezelés). Világszerte emelkedett a szövődményes appendicitisek aránya. Célkitűzés: Munkánk során a COVID–19-járványnak a gyermekkori akut appendicitisekre kifejtett hatását szerettük volna vizsgálni: lett-e több perforált eset? Módszerek: A 2012 és 2020 között akut vakbélgyulladás miatt operált gyermekeket vizsgáltuk, külön, havi bontásban a 2020-as eseteket. A szövettani diagnózis alapján perforált és nem perforált appendicitis csoportokat alkottunk. A 2020-ban operált betegek COVID–19-statusát is rögzítettük. Statisztikai analízisre a khi2-próbát (’chi2 test for trend’) és a Fisher-féle egzakt tesztet alkalmaztuk. Eredmények: A vizsgált időszakban 1343 appendectomia történt, többségében nem perforált akut appendicitis miatt (1166/1343). 2015-től kezdődően a perforált esetek aránya szignifikáns emelkedést mutat (p = 0,0002). Az igazoltan COVID–19-pozitív betegek között magasabb volt a perforáltak aránya (5/8), mint az igazoltan negatív betegek között (15/92) (p = 0,0075). Megbeszélés: A nemzetközi trendeknek megfelelően 2020-ban osztályunkon is magasabb volt a perforált appendicitisek aránya, mint a korábbi években. Ez az emelkedés 2015-től tart, a pandémiával nem mutat szoros összefüggést. A perforált appendicitisek COVID–19-pozitív betegek között észlelt magas arányának okát nem ismerjük. Következtetés: További vizsgálat indokolt annak feltárására, hogy mi okozza a perforált appendicitisek COVID–19-pozitív betegek között észlelt magas, illetve 2015 óta emelkedő rátáját. Orv Hetil. 2021; 162(16): 608–610. Summary. Introduction: As a result of the COVID-19 pandemic, the management of paediatric appendicitis has changed (open instead of laparoscopic appendectomy, antibiotic treatment). The number of complicated appendicitis cases increased worldwide. Objective: Our aim was to study the effect of the COVID-19 pandemic on paediatric acute appendicitis: has there been more perforated cases? Methods: Children operated because of acute appendicitis between 2012 and 2020 were studied. Cases from the year 2020 were analysed monthly. Patients were divided into perforated and non-perforated appendicitis groups according to their histological findings. COVID-19 status of patients in 2020 was studied. Chi2 test for trend and Fisher’s exact test were used for statistical analysis. Results: In the study period, 1343 appendectomies were performed. The majority of our cases were non-perforated (1166/1343). The rate of perforated appendicitis cases has been increasing from 2015 (p = 0.0002). The number of perforated cases was higher in COVID-19 positive patients (5/8) then in negative ones (15/92) (p = 0.0075). Discussion: In line with the international trend, more perforated appendicitis cases were treated in our departement in 2020. However, this increase started in 2015, and there is no correlation with the COVID-19 pandemic. The cause of the increased number of perforated cases in COVID-19 positive appendicitis patients is unknown. Conclusion: The causes of the high proportion of perforated cases in COVID-19 positive patients and the rising rate of perforated appendicitis cases since 2015 need further studies. Orv Hetil. 2021; 162(16): 608–610.

scholarly journals Risk factors for intra-abdominal abscess following laparoscopic appendectomy for acute appendicitis: a retrospective cohort study on 2076 patients

2020 ◽  
Vol 72 (4) ◽  
pp. 1175-1180
Author(s):  
Dario Tartaglia ◽  
Lorenzo Maria Fatucchi ◽  
Alessio Mazzoni ◽  
Mario Miccoli ◽  
Lorenzo Piccini ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Abdominal Abscess

scholarly journals Risk factors for serious morbidity, prolonged length of stay and hospital readmission after laparoscopic appendectomy - results from Pol-LA (Polish Laparoscopic Appendectomy) multicenter large cohort study

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Maciej Walędziak ◽  
Anna Lasek ◽  
Michał Wysocki ◽  
Michael Su ◽  
Maciej Bobowicz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Adverse Events ◽  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Hospital Readmission ◽  
Univariate Analysis ◽  
Complicated Appendicitis ◽  
Multivariate Model ◽  
Adverse Outcomes ◽  
Primary Procedure

Abstract Laparoscopic appendectomy (LA) for treatment of acute appendicitis has gained acceptance with its considerable benefits over open appendectomy. LA, however, can involve some adverse outcomes: morbidity, prolonged length of hospital stay (LOS) and hospital readmission. Identification of predictive factors may help to identify and tailor treatment for patients with higher risk of these adverse events. Our aim was to identify risk factors for serious morbidity, prolonged LOS and hospital readmission after LA. A database compiled information of patients admitted for acute appendicitis from eighteen Polish and German surgical centers. It included factors related to the patient characteristics, peri- and postoperative period. Univariate and multivariate logistic regression models were used to identify risk factors for serious perioperative complications, prolonged LOS, and hospital readmissions in acute appendicitis cases. 4618 laparoscopic appendectomy patients were included. First, although several risk factors for serious perioperative complications (C-D III-V) were found in the univariate analysis, in the multivariate model only the presence of intraoperative adverse events (OR 4.09, 95% CI 1.32–12.65, p = 0.014) and complicated appendicitis (OR 3.63, 95% CI 1.74–7.61, p = 0.001) was statistically significant. Second, prolonged LOS was associated with the presence of complicated appendicitis (OR 2.8, 95% CI: 1.53–5.12, p = 0.001), postoperative morbidity (OR 5.01, 95% CI: 2.33–10.75, p < 0.001), conversions (OR 6.48, 95% CI: 3.48–12.08, p < 0.001) and reinterventions after primary procedure (OR 8.79, 95% CI: 3.2–24.14, p < 0.001) in the multivariate model. Third, although several risk factors for hospital readmissions were found in univariate analysis, in the multivariate model only the presence of postoperative complications (OR 10.33, 95% CI: 4.27–25.00), reintervention after primary procedure (OR 5.62, 95% CI: 2.17–14.54), and LA performed by resident (OR 1.96, 95% CI: 1.03–3.70) remained significant. Laparoscopic appendectomy is a safe procedure associated with low rates of complications, prolonged LOS, and readmissions. Risk factors for these adverse events include complicated appendicitis, postoperative morbidity, conversion, and re-intervention after the primary procedure. Any occurrence of these factors during treatment should alert the healthcare team to identify the patients that require more customized treatment to minimize the risk for adverse outcomes.

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.

Laparoscopic Appendectomy: A Report on 1164 Operations at a Single-Institution, Safety-Net Hospital

2018 ◽  
Vol 84 (6) ◽  
pp. 1110-1116 ◽  
Author(s):  
Ryan P. Dumas ◽  
Madhu Subramanian ◽  
Erica Hodgman ◽  
Michelle Arevalo ◽  
Gabriella Nguyen ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Open Appendectomy ◽  
Standard Of Care ◽  
Safety Net ◽  
Complicated Appendicitis ◽  
High Risk Population ◽  
Surgical Morbidity ◽  
Safety Net Hospital

Laparoscopic appendectomy (LA) is the standard of care for the treatment of acute appendicitis. There is an ongoing debate regarding the optimal management of appendicitis, which led us to study outcomes after an appendectomy at a large safety-net hospital. We hypothesize that despite a high-risk population, LA remains a safe and effective treatment for acute appendicitis. A retrospective review was performed of all patients who underwent an appendectomy from 2011 to 2013. The primary end point was significant morbidity defined as a score of three or greater on the Clavien-Dindo scale of surgical morbidity. Thousand hundred and sixty-four patients underwent an appendectomy. A total of 1102 (94.7%) patients underwent either an LA or laparoscopic converted to open appendectomy, and 62 (5.3%) patients underwent an open appendectomy (OA). Two hundred and forty six patients (21.1%) had complicated appendicitis. Laparoscopic converted to OA conversion rate was 4.4 per cent and differed between years (P < 0.001). LA had a significantly shorter length of stay, shorter length of postoperative antibiotics, and less postoperative morbidity. When limited to only patients with complicated appendicitis, major morbidity was still greater in the OA group (22.6 vs 52.0%, P = 0.001). Length of stay was significantly longer in the OA group [3.42 (2.01, 5.97) vs 7.04 (5.05, 10.13), P < 0.001]. Odds for complication were 2.6 times greater in the OA group compared with the LA group. In the absence of peritonitis and systemic illness necessitating urgent laparotomy, patients who are laparoscopic surgical candidates should be offered an LA. Our study demonstrates that these patients have better outcomes and shorter hospital stays.

scholarly journals Primerjava laparoskopske apendektomije pri enostavnem in zapletenem vnetju slepiča

2017 ◽  
Vol 86 ◽  
Author(s):  
Matjaž Križaj ◽  
Erik Štrumbelj ◽  
Stanislav Mahne
Keyword(s):  
Postoperative Complications ◽  
Acute Appendicitis ◽  
Hospital Stay ◽  
Laparoscopic Appendectomy ◽  
Conversion Rate ◽  
Complicated Appendicitis ◽  
Early Postoperative Complications ◽  
Stump Closure ◽  
Significant Difference ◽  
Diagnostic Modalities

Background: Laparoscopic appendectomy has been gaining ground as a gold standard for the treatment of acute appendicitis. For complex inflammation there is no common opinion. A higher conversion rate, longer operative time, higher incidence of abscess formation and longer hospitalization are being reported. The aim of our study was to compare the diagnostic modalities, treatment and postoperative complications in uncomplicated and complicated appendicitis.Methods: In our institution laparoscopic appendectomy is the method of choice for the treatment of every type of appendicitis. In our retrospective analysis, all patients with acute appendicitis operated on in the years 2013 and 2014 were included. Among 273 patients, 19 were excluded due to primary open procedure and one who underwent revision surgery for other disease and had appendectomy performed. In 253 patients we observed the proportion of the postoperative complications in uncomplicated and complicated cases with respect to patients’ age, period of the year, duration of hospital stay, diagnostic modalities, drainage of the abdominal cavity, conversion rate and stump closure.Results: The analysis showed a steep increase of complicated appendicitis in elderly population, but there were no significant differences regarding period of the year (χ2 test, p = 0.158). The hospital stay was longer in complicated cases (5.94 days v. 3.049 days). When a preoperative CT scan was performed, cases were more often complicated (CT 0.654, no CT 0.229; χ2 test, p < 0.001), as was the proportion of drain insertions during surgery (0.5490 v. 0.065; χ2 test, p < 0.001). The proportion of clips for the stump closure was higher in the uncomplicated group (0.717 v. 0.521; χ2 test, p = 0.005). The rate of early postoperative complications and conversion rate revealed no significant difference.Conclusions: We have found out there is a difference in diagnostic modalities and treatment options in uncomplicated and complicated appendicitis, but no significant difference in the conversion rate and early postoperative complications. Our analysis suggests that laparoscopic appendectomy is a safe method in all types of appendicitis.

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.

scholarly journals Laparoscopic versus open appendectomy during pregnancy

2017 ◽  
Vol 4 (8) ◽  
pp. 2387 ◽  
Author(s):  
Mohammed M. Alkatary ◽  
Nagwan A. Bahgat
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Preterm Labor ◽  
Open Appendectomy ◽  
Laparoscopic Group ◽  
Fetal Outcome ◽  
Pathological Examination ◽  
Normal Appendix ◽  
Laparoscopic Versus Open Appendectomy

Background: Various causes can be claimed for abdominal pain during pregnancy. Acute appendicitis is the most common cause of abdominal pain during pregnancy. Diagnosis of acute appendicitis during pregnancy is a quiet challenging due to anatomical and physiological changes that occur during pregnancy.Methods: On the period from January 2010 to January 2012we reviewed the number of pregnant patients presented to our facility by abdominal pain and diagnosed as acute appendicitis. Total number was 23 patients. 2 patients were excluded as their magnetic resonance imaging showed normal appendix and were discharged. 6 patients presented on the 1st trimester, 7 patients presented on the 2nd trimester and 8 patients on the 3rd trimester. Laparoscopic appendectomy performed in 9 patients while 12 patients had open appendectomy.Results: The operative time on the laparoscopic group ranged from 50-80 minutes while on the open appendectomy ranged from 40-60 minutes. The length of stay after laparoscopic procedure was 1.5-3 days in comparison to 3-5 days following open appendectomy. Postoperative wound infection detected in 2 patients after open appendectomy (16%) compared with 1 patient (11%) following laparoscopic appendectomy. The postoperative pathology was classified as normal appendix, suppurated appendix and complicated appendix. Table 2 showed the postoperative pathological examination. Preterm labor detected in one patient only had open appendectomy. Fetal outcome was evaluated by Apgar scoring together with fetal length and weight after delivery with no significant abnormality.Conclusions: Laparoscopic appendectomy is safe for both the mother and the fetus during pregnancy irrespective of gestational age, and the procedure is associated with a low risk of post-operative complications. 

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