Max Knaapen1, Paul van Amstel2, Tim van Amstel2, Sarah-May M L The2, Roel Bakx2, Ernest L W E van Heurn2, Ramon R Gorter2. 1. Department of Paediatric Surgery, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam & Vrije Universiteit Amsterdam, PO Box 22660, 1100DD, Amsterdam, The Netherlands. M.Knaapen@amsterdamumc.nl. 2. Department of Paediatric Surgery, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam & Vrije Universiteit Amsterdam, PO Box 22660, 1100DD, Amsterdam, The Netherlands.
Abstract
PURPOSE: In general, an appendectomy is presumed to have a limited burden of disease. However, in current literature, reported complication rates vary. This study aims to provide additional insights in the incidence of post-appendectomy complications in children with acute appendicitis. METHODS: This retrospective cohort study included children (0-17 years old) that underwent appendectomy at our tertiary referral centre for suspected acute appendicitis (January 2011-December 2018). Children referred to our centre, and those that underwent non-operative treatment were excluded. Post-appendectomy complications were recorded from electronic medical charts using predefined definitions and classified as severe (Clavien-Dindo III-IV) or less severe (Clavien-Dindo I-II). RESULTS: A total of 131 children were included. Simple and complex appendicitis was diagnosed in 66 (50%) and 60 (46%) children, respectively. A non-inflamed appendix was seen in five (4%) children. One or more complications were identified in 33 (25%) patients. Eight (12%) children with simple appendicitis developed a complication, three of these were severe. In children with complex appendicitis, 23 (38%) children developed a complication, 14 of these were severe. CONCLUSION: This study shows a high rate of complications compared with current literature, both in children with simple and complex appendicitis. This is probably the result of our definition of complications and being a tertiary referral centre receiving more severe appendicitis cases. However, these results still show that appendectomy is not always a routine procedure with only few complications. Substantiating the need to keep optimizing treatment for children with appendicitis.
PURPOSE: In general, an appendectomy is presumed to have a limited burden of disease. However, in current literature, reported complication rates vary. This study aims to provide additional insights in the incidence of post-appendectomy complications in children with acute appendicitis. METHODS: This retrospective cohort study included children (0-17 years old) that underwent appendectomy at our tertiary referral centre for suspected acute appendicitis (January 2011-December 2018). Children referred to our centre, and those that underwent non-operative treatment were excluded. Post-appendectomy complications were recorded from electronic medical charts using predefined definitions and classified as severe (Clavien-Dindo III-IV) or less severe (Clavien-Dindo I-II). RESULTS: A total of 131 children were included. Simple and complex appendicitis was diagnosed in 66 (50%) and 60 (46%) children, respectively. A non-inflamed appendix was seen in five (4%) children. One or more complications were identified in 33 (25%) patients. Eight (12%) children with simple appendicitis developed a complication, three of these were severe. In children with complex appendicitis, 23 (38%) children developed a complication, 14 of these were severe. CONCLUSION: This study shows a high rate of complications compared with current literature, both in children with simple and complex appendicitis. This is probably the result of our definition of complications and being a tertiary referral centre receiving more severe appendicitis cases. However, these results still show that appendectomy is not always a routine procedure with only few complications. Substantiating the need to keep optimizing treatment for children with appendicitis.
Authors: Sheraz R Markar; Simon Blackburn; Richard Cobb; Alan Karthikesalingam; Jessica Evans; James Kinross; Omar Faiz Journal: J Gastrointest Surg Date: 2012-07-19 Impact factor: 3.452
Authors: Danielle B Cameron; Regan Williams; Yimin Geng; Ankush Gosain; Meghan A Arnold; Yigit S Guner; Martin L Blakely; Cynthia D Downard; Adam B Goldin; Julia Grabowski; Dave R Lal; Roshni Dasgupta; Robert Baird; Robert L Gates; Julia Shelton; Tim Jancelewicz; Shawn J Rangel; Mary T Austin Journal: J Pediatr Surg Date: 2017-11-20 Impact factor: 2.545
Authors: Max Knaapen; Johanna H van der Lee; Roel Bakx; Sarah-May L The; Ernst W E van Heurn; Hugo A Heij; Ramon R Gorter Journal: BMJ Open Date: 2017-11-15 Impact factor: 2.692
Authors: M D Bolmers; C C van Rossem; R R Gorter; W A Bemelman; A A W van Geloven; H A Heij Journal: Pediatr Surg Int Date: 2018-03-09 Impact factor: 1.827
Authors: Ramon R Gorter; Hasan H Eker; Marguerite A W Gorter-Stam; Gabor S A Abis; Amish Acharya; Marjolein Ankersmit; Stavros A Antoniou; Simone Arolfo; Benjamin Babic; Luigi Boni; Marlieke Bruntink; Dieuwertje A van Dam; Barbara Defoort; Charlotte L Deijen; F Borja DeLacy; Peter Mnyh Go; Annelieke M K Harmsen; Rick S van den Helder; Florin Iordache; Johannes C F Ket; Filip E Muysoms; M Mahir Ozmen; Michail Papoulas; Michael Rhodes; Jennifer Straatman; Mark Tenhagen; Victor Turrado; Andras Vereczkei; Ramon Vilallonga; Jort D Deelder; Jaap Bonjer Journal: Surg Endosc Date: 2016-09-22 Impact factor: 4.584