Katelyn A Young1, Nina M Neuhaus2, Marcus Fluck3, Joseph A Blansfield4, Marie A Hunsinger5, Mohsen M Shabahang6, Denise M Torres7, Kenneth A Widom8, Jeffrey L Wild9. 1. Department of General Surgery, Geisinger Medical Center, 100 N. Academy Avenue, Danville, PA, USA. Electronic address: kayoung1@geisinger.edu. 2. Department of General Surgery, Geisinger Medical Center, 100 N. Academy Avenue, Danville, PA, USA. Electronic address: nmneuhaus@geisinger.edu. 3. Department of General Surgery, Geisinger Medical Center, 100 N. Academy Avenue, Danville, PA, USA. Electronic address: mfluck1@geisinger.edu. 4. Department of General Surgery, Geisinger Medical Center, 100 N. Academy Avenue, Danville, PA, USA. Electronic address: jblansfield1@geisinger.edu. 5. Department of General Surgery, Geisinger Medical Center, 100 N. Academy Avenue, Danville, PA, USA. Electronic address: mahunsinger@geisinger.edu. 6. Department of General Surgery, Geisinger Medical Center, 100 N. Academy Avenue, Danville, PA, USA. Electronic address: mmshabahang@geisinger.edu. 7. Department of General Surgery, Geisinger Medical Center, 100 N. Academy Avenue, Danville, PA, USA. Electronic address: dmtorres@geisinger.edu. 8. Department of General Surgery, Geisinger Medical Center, 100 N. Academy Avenue, Danville, PA, USA. Electronic address: kawidom@geisinger.edu. 9. Department of General Surgery, Geisinger Medical Center, 100 N. Academy Avenue, Danville, PA, USA. Electronic address: jlwild@geisinger.edu.
Abstract
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. Sixty individuals underwent AA. The remaining 35 patients initially underwent NOM: 14 underwent EIA, nine (25.7%) failed NOM, 12 never underwent surgery. All patients failing NOM had an open operation with most (55.6%) requiring bowel resection. AA and EIA were comparable in surgical approach, bowel resection and post-operative readmission. However, AA demonstrated a lower incidence of bowel resection (3.3% vs 17.1%, P = 0.048) when compared to all patients initially undergoing NOM. CONCLUSIONS: Due to the high incidence of failed NOM and the morbidity associated with failure, AA may be appropriate for CA.
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. Sixty individuals underwent AA. The remaining 35 patients initially underwent NOM: 14 underwent EIA, nine (25.7%) failed NOM, 12 never underwent surgery. All patients failing NOM had an open operation with most (55.6%) requiring bowel resection. AA and EIA were comparable in surgical approach, bowel resection and post-operative readmission. However, AA demonstrated a lower incidence of bowel resection (3.3% vs 17.1%, P = 0.048) when compared to all patients initially undergoing NOM. CONCLUSIONS: Due to the high incidence of failed NOM and the morbidity associated with failure, AA may be appropriate for CA.
Authors: S Shekarriz; T Keck; P Kujath; J Shekarriz; T Strate; R Keller; E Schlöricke; J Nolde; A Ehlert; H Shekarriz Journal: Int J Colorectal Dis Date: 2019-01-22 Impact factor: 2.571
Authors: Erica L Riedesel; Blake C Weber; Matthew W Shore; Randi S Cartmill; Daniel J Ostlie; Charles M Leys; Kara G Gill; Jonathan E Kohler Journal: Pediatr Radiol Date: 2019-07-24
Authors: Salomone Di Saverio; Mauro Podda; Belinda De Simone; Marco Ceresoli; Goran Augustin; Alice Gori; Marja Boermeester; Massimo Sartelli; Federico Coccolini; Antonio Tarasconi; Nicola De' Angelis; Dieter G Weber; Matti Tolonen; Arianna Birindelli; Walter Biffl; Ernest E Moore; Michael Kelly; Kjetil Soreide; Jeffry Kashuk; Richard Ten Broek; Carlos Augusto Gomes; Michael Sugrue; Richard Justin Davies; Dimitrios Damaskos; Ari Leppäniemi; Andrew Kirkpatrick; Andrew B Peitzman; Gustavo P Fraga; Ronald V Maier; Raul Coimbra; Massimo Chiarugi; Gabriele Sganga; Adolfo Pisanu; Gian Luigi De' Angelis; Edward Tan; Harry Van Goor; Francesco Pata; Isidoro Di Carlo; Osvaldo Chiara; Andrey Litvin; Fabio C Campanile; Boris Sakakushev; Gia Tomadze; Zaza Demetrashvili; Rifat Latifi; Fakri Abu-Zidan; Oreste Romeo; Helmut Segovia-Lohse; Gianluca Baiocchi; David Costa; Sandro Rizoli; Zsolt J Balogh; Cino Bendinelli; Thomas Scalea; Rao Ivatury; George Velmahos; Roland Andersson; Yoram Kluger; Luca Ansaloni; Fausto Catena Journal: World J Emerg Surg Date: 2020-04-15 Impact factor: 5.469