Michal Pedziwiatr1, Anna Lasek1, Michal Wysocki1, Judene Mavrikis2, Piotr Mysliwiec3, Maciej Bobowicz4, Wojciech Karcz5, Maciej Michalik6, Wojciech Makarewicz7, Piotr Major1, Mateusz Rubinkiewicz1, Tomasz Stefura2, Jakub Kenig8, Malgorzata Polanska-Plachta9, Pol-LA Polish Laparoscopic Appendectomy10. 1. 2nd Department of General Surgery, Jagiellonian University Medical College, Kraków-Poland. 2. Center for Research, Training and Innovation in Surgery (CERTAIN Surgery), Kraków-Poland. 3. 1st Department of General and Endocrinological Surgery, Medical University of Bialystok, Bialystok-Poland. 4. Department of Surgical Oncology, Medical University of Gdansk, Gdansk-Poland. 5. Department of General, Visceral and Transplant Surgery, Ludwig Maximilian University, Munich-Germany. 6. Department of General, Minimally Invasive and Elderly Surgery, University of Warmia and Mazury, Olsztyn-Poland. 7. Department of General Surgery and Surgical Oncology, Specialist Hospital in Kościerzyna, Kościerzyna-Poland. 8. Department of General, Oncological and Geriatric Surgery, Jagiellonian University Medical College, Krakow-Poland. 9. 2nd Department of General, Vascular and Oncological Surgery, Medical University of Warsaw, Second Faculty of Medicine, Warsaw-Poland. 10. Polish Laparoscopic Appendectomy Collaborative Study Group.
Abstract
BACKGROUND: Preoperative classification of complicated and uncomplicated appendicitis (AA) is challenging. However, the differences in surgical outcomes necessitate the establishment of risk factors in developing, complicated AA. This study was an analysis of the clinical outcomes of laparoscopic appendectomies (LA), as well as preoperative risk factors for the development of complicated AA. METHODS: The data of 618 patients who underwent LA in 18 surgical units across Poland and Germany were collected in an online web-based database created by the Polish Videosurgery Society. The surgical outcomes of patients with complicated and uncomplicated appendicitis were compared. Uni- and multivariate logistic regression models were used to establish risk factors for the development of complicated appendicitis. RESULTS: In all, 1269 (27.5%) patients underwent LA for complicated appendicitis (Group 1) and 3349 (72.5%) for uncomplicated appendicitis (Group 2). The conversion rate, number of intra-operative adverse events, re-intervention rate, postoperative complications, and readmission rate was greater in Group 1. The preoperative risk factors associated with complicated appendicitis were: female sex (Odds ratio [OR]: 1.58), obesity (OR: 1.51), age >50 years (OR: 1.51), symptoms >48 hours (OR: 2.18), high Alvarado score (OR: 1.29 with every point), and C-reactive protein level >100 mg/L (OR: 3.92). CONCLUSION: Several demographic and clinical risk factors for complicated AA were identified. LA for complicated appendicitis was associated with poorer outcomes.
BACKGROUND: Preoperative classification of complicated and uncomplicated appendicitis (AA) is challenging. However, the differences in surgical outcomes necessitate the establishment of risk factors in developing, complicated AA. This study was an analysis of the clinical outcomes of laparoscopic appendectomies (LA), as well as preoperative risk factors for the development of complicated AA. METHODS: The data of 618 patients who underwent LA in 18 surgical units across Poland and Germany were collected in an online web-based database created by the Polish Videosurgery Society. The surgical outcomes of patients with complicated and uncomplicated appendicitis were compared. Uni- and multivariate logistic regression models were used to establish risk factors for the development of complicated appendicitis. RESULTS: In all, 1269 (27.5%) patients underwent LA for complicated appendicitis (Group 1) and 3349 (72.5%) for uncomplicated appendicitis (Group 2). The conversion rate, number of intra-operative adverse events, re-intervention rate, postoperative complications, and readmission rate was greater in Group 1. The preoperative risk factors associated with complicated appendicitis were: female sex (Odds ratio [OR]: 1.58), obesity (OR: 1.51), age >50 years (OR: 1.51), symptoms >48 hours (OR: 2.18), high Alvarado score (OR: 1.29 with every point), and C-reactive protein level >100 mg/L (OR: 3.92). CONCLUSION: Several demographic and clinical risk factors for complicated AA were identified. LA for complicated appendicitis was associated with poorer outcomes.
Authors: Maciej Walędziak; Anna Lasek; Michał Wysocki; Michael Su; Maciej Bobowicz; Piotr Myśliwiec; Kamil Astapczyk; Mateusz Burdzel; Karolina Chruściel; Rafał Cygan; Wojciech Czubek; Natalia Dowgiałło-Wnukiewicz; Jakub Droś; Paula Franczak; Wacław Hołówko; Artur Kacprzyk; Wojciech Konrad Karcz; Jakub Kenig; Paweł Konrad; Arkadiusz Kopiejć; Adam Kot; Karolina Krakowska; Maciej Kukla; Agnieszka Leszko; Leszek Łozowski; Piotr Major; Wojciech Makarewicz; Paulina Malinowska-Torbicz; Maciej Matyja; Maciej Michalik; Adam Niekurzak; Damian Nowiński; Radomir Ostaszewski; Małgorzata Pabis; Małgorzata Polańska-Płachta; Mateusz Rubinkiewicz; Tomasz Stefura; Anna Stępień; Paweł Szabat; Rafał Śmiechowski; Sebastian Tomaszewski; Viktor von Ehrlich-Treuenstätt; Maciej Wasilczuk; Mateusz Wierdak; Anna Wojdyła; Jan Wojciech Wroński; Leszek Zwolakiewicz; Michał Pędziwiatr Journal: Sci Rep Date: 2019-10-15 Impact factor: 4.379
Authors: Hamzah Sukiman; Abdul Malek Mohamad; Muhammad Firdaus Nasution Raduan; Mohd Nur Afiq Mohd Yasim; Muhammad Ikhwan Mat Lazim Journal: Malays J Med Sci Date: 2021-10-26