Treatment of acute appendicitis: Urgent surgery or emergent surgery?
Yıl: 2020 Cilt: 26 Sayı: 5 Sayfa Aralığı: 742 - 745 Metin Dili: İngilizce DOI: 10.14744/tjtes.2020.23236 İndeks Tarihi: 03-11-2020
Treatment of acute appendicitis: Urgent surgery or emergent surgery?
Öz: BACKGROUND: The standard treatment of acute appendicitis, which is a rapidly progressive inflammatory disease, remains surgery.However, several studies have suggested antibiotics treatment for acute appendicitis, especially in centers where surgery at all hoursis not possible. Therefore, in this study, we investigated the relationship between the preoperative waiting period and postoperativecomplications in patients who underwent interval surgery following conservative management during the same admission.METHODS: All patients who were diagnosed with uncomplicated acute appendicitis between October 2014 and February 2015and underwent surgery at a single center were included in this retrospective study. Patients were divided into two groups based onthe waiting period between the diagnosis and the time of surgery: group A (emergency, waiting period <10 h) and group B (urgency,waiting period ≥10 h). The demographic features, preoperative waiting period, antibiotics use, pathological diagnosis, postoperativecomplications, length of hospital stay, and readmission were compared between the two groups.RESULTS: This study comprised 160 patients, including 79 and 81 patients in groups A and B, respectively. The demographic features,comorbidities, and pathological diagnosis were comparable between the two groups. The average preoperative waiting period wassignificantly longer in group B than in group A. However, the mean length of hospital stay and the rate of postoperative complications,including infections at the surgical sites and intra-abdominal abscesses, were similar between the two groups.CONCLUSION: Our analyses revealed that there were no disadvantages associated with a longer preoperative waiting period inpatients diagnosed with uncomplicated appendicitis.
Anahtar Kelime: Akut apandisit tedavisinde acil cerrahi veya gecikmiş cerrahinin yeri
Öz: AMAÇ: Akut apandisit, hızla ilerleyen bir iltihabi hastalık olup, standart tedavisi acil cerrahi girişimdir. Bununla birlikte, son zamanlarda bazı olgularda yarı elektif olarak apendektomi planlanabileceği konusunda görüşler belirtilmektedir. Bu çalışmamızdaki amacımız zorunlu nedenlere bağlı ameliyatın ertelendiği durumlarda ve komplike olmayan olgularda sıvı ve antibiyotik tedavisi altında güvenli olarak apendektomi uygulanabileceğini ortaya koymaktır. GEREÇ VE YÖNTEM: Çalışmamız Ekim 2014–Şubat 2015 tarihleri arasında akut apandisit ön tanısı ile apendektomi yapılmış 160 olguyu içermektedir. Hastalar, ameliyat öncesi bekleme süresi 10 saat altı ve üstü olacak şekilde iki gruba ayrıldı ve patoloji sonuçları, komplikasyon oranları ve hastanede kalış sürelerine göre karşılaştırıldı. BULGULAR: Çalışmaya 160 hasta alındı. Grup A’da 79, Grup B’de 81 hasta vardı. Hastaların demografik verileri, patoloji raporları ve komorbid durumları incelendiğinde istatistiksel anlamlı fark yoktu. Ortalama ameliyat öncesi bekleme süresi ve ameliyat süreleri karşılaştırıldığında gruplar arasında anlamlı fark saptandı. Hastaneden kalış süreleri, yara yeri enfeksiyonu ve karıniçi apse açısından her iki grup arasında anlamlı fark saptanmadı. TARTIŞMA: Komplike olmayan akut apandisit tanısı alan hastaların, acil serviste ameliyat öncesi uygun medikal tedavi ve gözlem altında geçirdiği bekleme süresinin, komplikasyon ve hastanede yatış süresi üzerine olumsuz etkisi yoktur.
Anahtar Kelime: Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
- 1. Humes DJ, Simpson J. Acute appendicitis. BMJ 2006;333:530−4.
- 2. Blomqvist P, Ljung H, Nyrén O, Ekbom A. Appendectomy in Sweden 1989-1993 assessed by the Inpatient Registry. J Clin Epidemiol 1998;51:859−65.
- 3. Margenthaler JA, Longo WE, Virgo KS, Johnson FE, Oprian CA, Henderson WG, et al. Risk factors for adverse outcomes after the surgical treatment of appendicitis in adults. Ann Surg 2003;238:59−66.
- 4. Yardeni D, Hirschl RB, Drongowski RA, Teitelbaum DH, Geiger JD, Coran AG. Delayed versus immediate surgery in acute appendicitis: do we need to operate during the night?. J Pediatr Surg 2004;39:464−9.
- 5. Surana R, Quinn F, Puri P. Is it necessary to perform appendicectomy in the middle of the night in children?. BMJ 1993;306:1168.
- 6. Bachoo P, Mahomed AA, Ninan GK, Youngson GG. Acute appendicitis: the continuing role for active observation. Pediatr Surg Int 2001;17:125−8.
- 7. Pittman-Waller VA, Myers JG, Stewart RM, Dent DL, Page CP, Gray GA, et al. Appendicitis: why so complicated? Analysis of 5755 consecutive appendectomies. Am Surg 2000;66:548−54.
- 8. Lee HJ, Park YH, Kim JI, Choi PW, Park JH, Heo TG, et al. Comparison of clinical outcomes and hospital cost between open appendectomy and laparoscopic appendectomy. J Korean Surg Soc 2011;81:321−5.
- 9. Andersson RE, Petzold MG. Nonsurgical treatment of appendiceal abscess or phlegmon: a systematic review and meta-analysis. Ann Surg 2007;246:741−8.
- 10. Lugo JZ, Avgerinos DV, Lefkowitz AJ, Seigerman ME, Zahir IS, Lo AY, et al. Can interval appendectomy be justified following conservative treatment of perforated acute appendicitis? J Surg Res 2010;164:91−4.
- 11. Kaya C, Demir U, Arısoy M, Okul Ş, Bostancı Ö, Köksal HM, et al. Does interval appendectomy necessary for the patients diagnosed as appendicular masses? SETB 2012;46:189−92.
- 12. Sakorafas GH, Mastoraki A, Lappas C, Sampanis D, Danias N, Smyrniotis V. Conservative treatment of acute appendicitis: heresy or an effective and acceptable alternative to surgery?. Eur J Gastroenterol Hepatol 2011;23:121−7.
- 13. Teixeira PG, Sivrikoz E, Inaba K, Talving P, Lam L, Demetriades D. Appendectomy timing: waiting until the next morning increases the risk of surgical site infections. Ann Surg 2012;256:538−43.
- 14. Udgiri N, Curras E, Kella VK, Nagpal K, Cosgrove J. Appendicitis, is it an emergency?. Am Surg 2011;77:898−901.
- 15. Ditillo MF, Dziura JD, Rabinovici R. Is it safe to delay appendectomy in adults with acute appendicitis?. Ann Surg 2006;244:656−60.
- 16. Earley AS, Pryor JP, Kim PK, Hedrick JH, Kurichi JE, Minogue AC, et al. An acute care surgery model improves outcomes in patients with appendicitis. Ann Surg 2006;244:498−504.
- 17. Giraudo G, Baracchi F, Pellegrino L, Dal Corso HM, Borghi F. Prompt or delayed appendectomy? Influence of timing of surgery for acute appendicitis. Surg Today 2013;43:392−6.
- 18. Nagpal K, Udgiri N, Sharma N, Curras E, Cosgrove JM, Farkas DT. Delaying an appendectomy: is it safe? Am Surg 2012;78:897−900.
- 19. Stahlfeld K, Hower J, Homitsky S, Madden J. Is acute appendicitis a surgical emergency?. Am Surg 2007;73:626−30.
- 20. Eastridge BJ, Hamilton EC, O’Keefe GE, Rege RV, Valentine RJ, Jones DJ, et al. Effect of sleep deprivation on the performance of simulated laparoscopic surgical skill. Am J Surg 2003;186:169−74.
- 21. Kahol K, Leyba MJ, Deka M, Deka V, Mayes S, Smith M, et al. Effect of fatigue on psychomotor and cognitive skills. Am J Surg 2008;195:195−204.
- 22. Busch M, Gutzwiller FS, Aellig S, Kuettel R, Metzger U, Zingg U. In-hospital delay increases the risk of perforation in adults with appendicitis. World J Surg 2011;35:1626−33.
- 23. Abou-Nukta F, Bakhos C, Arroyo K, Koo Y, Martin J, Reinhold R, et al. Effects of delaying appendectomy for acute appendicitis for 12 to 24 hours. Arch Surg 2006;141:504−6; discussioin 506−7.
- 24. United Kingdom National Surgical Research Collaborative, Bhangu A. Safety of short, in-hospital delays before surgery for acute appendicitis: multicentre cohort study, systematic review, and meta-analysis. Ann Surg 2014;259:894−903.
| APA | BOZKURT E, Celayir M (2020). Treatment of acute appendicitis: Urgent surgery or emergent surgery?. , 742 - 745. 10.14744/tjtes.2020.23236 |
| Chicago | BOZKURT EMRE,Celayir Mustafa Fevzi Treatment of acute appendicitis: Urgent surgery or emergent surgery?. (2020): 742 - 745. 10.14744/tjtes.2020.23236 |
| MLA | BOZKURT EMRE,Celayir Mustafa Fevzi Treatment of acute appendicitis: Urgent surgery or emergent surgery?. , 2020, ss.742 - 745. 10.14744/tjtes.2020.23236 |
| AMA | BOZKURT E,Celayir M Treatment of acute appendicitis: Urgent surgery or emergent surgery?. . 2020; 742 - 745. 10.14744/tjtes.2020.23236 |
| Vancouver | BOZKURT E,Celayir M Treatment of acute appendicitis: Urgent surgery or emergent surgery?. . 2020; 742 - 745. 10.14744/tjtes.2020.23236 |
| IEEE | BOZKURT E,Celayir M "Treatment of acute appendicitis: Urgent surgery or emergent surgery?." , ss.742 - 745, 2020. 10.14744/tjtes.2020.23236 |
| ISNAD | BOZKURT, EMRE - Celayir, Mustafa Fevzi. "Treatment of acute appendicitis: Urgent surgery or emergent surgery?". (2020), 742-745. https://doi.org/10.14744/tjtes.2020.23236 |
| APA | BOZKURT E, Celayir M (2020). Treatment of acute appendicitis: Urgent surgery or emergent surgery?. Ulusal Travma ve Acil Cerrahi Dergisi, 26(5), 742 - 745. 10.14744/tjtes.2020.23236 |
| Chicago | BOZKURT EMRE,Celayir Mustafa Fevzi Treatment of acute appendicitis: Urgent surgery or emergent surgery?. Ulusal Travma ve Acil Cerrahi Dergisi 26, no.5 (2020): 742 - 745. 10.14744/tjtes.2020.23236 |
| MLA | BOZKURT EMRE,Celayir Mustafa Fevzi Treatment of acute appendicitis: Urgent surgery or emergent surgery?. Ulusal Travma ve Acil Cerrahi Dergisi, vol.26, no.5, 2020, ss.742 - 745. 10.14744/tjtes.2020.23236 |
| AMA | BOZKURT E,Celayir M Treatment of acute appendicitis: Urgent surgery or emergent surgery?. Ulusal Travma ve Acil Cerrahi Dergisi. 2020; 26(5): 742 - 745. 10.14744/tjtes.2020.23236 |
| Vancouver | BOZKURT E,Celayir M Treatment of acute appendicitis: Urgent surgery or emergent surgery?. Ulusal Travma ve Acil Cerrahi Dergisi. 2020; 26(5): 742 - 745. 10.14744/tjtes.2020.23236 |
| IEEE | BOZKURT E,Celayir M "Treatment of acute appendicitis: Urgent surgery or emergent surgery?." Ulusal Travma ve Acil Cerrahi Dergisi, 26, ss.742 - 745, 2020. 10.14744/tjtes.2020.23236 |
| ISNAD | BOZKURT, EMRE - Celayir, Mustafa Fevzi. "Treatment of acute appendicitis: Urgent surgery or emergent surgery?". Ulusal Travma ve Acil Cerrahi Dergisi 26/5 (2020), 742-745. https://doi.org/10.14744/tjtes.2020.23236 |
