Journal Article10.1007/S00464-019-06746-6
Laparoscopic appendicectomy is superior to open surgery for complicated appendicitis
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TL;DR: LA for complicated appendicitis has the same incidence of intra-abdominal abscesses but a significantly reduced morbidity, mortality and length of hospital stay compared with OA, and should be the preferred treatment for patients with complicated appendix.
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Abstract: Over the last three decades, laparoscopic appendicectomy (LA) has become the routine treatment for uncomplicated acute appendicitis. The role of laparoscopic surgery for complicated appendicitis (gangrenous and/or perforated) remains controversial due to concerns of an increased incidence of post-operative intra-abdominal abscesses (IAA) in LA compared to open appendicectomy (OA). The aim of this study was to compare the outcomes of LA versus OA for complicated appendicitis. A systematic literature search following PRISMA guidelines was conducted using MEDLINE, EMBASE, PubMed and Cochrane Database for randomised controlled trials (RCT) and case–control studies (CCS) that compared LA with OA for complicated appendicitis. Data from three RCT and 30 CCS on 6428 patients (OA 3,254, LA 3,174) were analysed. There was no significant difference in the rate of IAA (LA = 6.1% vs. OA = 4.6%; OR = 1.02, 95% CI = 0.71–1.47, p = 0.91). LA for complicated appendicitis has decreased overall post-operative morbidity (LA = 15.5% vs. OA = 22.7%; OR = 0.43, 95% CI: 0.31–0.59, p < 0.0001), wound infection, (LA = 4.7% vs. OA = 12.8%; OR = 0.26, 95% CI: 0.19–0.36, p < 0.001), respiratory complications (LA = 1.8% vs. OA = 6.4%; OR = 0.25, 95% CI: 0.13–0.49, p < 0.001), post-operative ileus/small bowel obstruction (LA = 3.1% vs. OA = 3.6%; OR = 0.65, 95% CI: 0.42–1.0, p = 0.048) and mortality rate (LA = 0% vs. OA = 0.4%; OR = 0.15, 95% CI: 0.04–0.61, p = 0.008). LA has a significantly shorter hospital stay (6.4 days vs. 8.9 days, p = 0.02) and earlier resumption of solid food (2.7 days vs. 3.7 days, p = 0.03). These results clearly demonstrate that LA for complicated appendicitis has the same incidence of IAA but a significantly reduced morbidity, mortality and length of hospital stay compared with OA. The finding of complicated appendicitis at laparoscopy is not an indication for conversion to open surgery. LA should be the preferred treatment for patients with complicated appendicitis.
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Prevention and Management of Postoperative Ileus: A Review of Current Practice
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Predictors for prolonged length of stay after laparoscopic appendectomy for complicated acute appendicitis in adults.
Aleix Martínez-Pérez,Carmen Payá-Llorente,Sandra Santarrufina-Martínez,Juan Carlos Sebastián-Tomás,Elías Martínez-López,Nicola de’Angelis +5 more
TL;DR: The intraoperative process of care has a clear impact on LOS after laparoscopic appendectomy for CAA in adults; therefore, the decision of whether to drain in these situations should be made more restrictively yet with judicious caution.
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Comparison of laparoscopic and open appendectomy on wound infection and healing in complicated appendicitis.
TL;DR: It is suggested that in terms of wound infection and wound healing, laparoscopic surgery should be the method of choice for patients with complicated appendicitis and drains should not be kept for a long time in patients undergoing appendectomy.
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Complicated appendicitis increases the hospital length of stay
TL;DR: In this article , a single-center retrospective review of patients who had undergone an appendectomy between 2016 and 2018 is presented, in which the patients were divided into two groups: complicated appendicitis versus simple appendix.
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Presentation and outcomes of acute appendicitis during COVID-19 pandemic: lessons learned from the Middle East—a multicentre prospective cohort study
Ayman El Nakeeb,Sameh Hany Emile,Ahmed AbdelMawla,Mohamed El-Mahdy Muhammad Attia,Mohamed Al-Zahrani,Ayman ElGamdi,Abd elwahab Nouh,Abdulaziz Alshahrani,Riyadh AlAreef,Taha Kayed,Hosamuddin Hamza,Ahmad Almalki,Fares Rayzah,Motaz N. Alsharif,Fares N. Alsharif,M. M. Mohammed +15 more
TL;DR: In this paper , the authors investigated the impact of the COVID-19 pandemic on the presentation management and outcomes of acute appendicitis (AA) in different centers in the Middle East.
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جراحی لاپاروسکوپیک در مقابل جراحی باز برای موارد مشکوک به آپاندیسیت
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TL;DR: The effects of laparoscopic appendectomy and open appendectomy with regard to benefits and harms are compared and two studies showed better quality of life scores following LA, but used different scales, and therefore no pooled estimates were presented.
Laparoscopic versus open surgery for suspected appendicitis
TL;DR: In those clinical settings where surgical expertise and equipment are available and affordable, diagnostic laparoscopy and LA (either in combination or separately) seem to have various advantages over OA.
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The Global Incidence of Appendicitis: A Systematic Review of Population-based Studies.
Mollie Ferris,Samuel Quan,Belle S. Kaplan,Natalie A. Molodecky,Chad G. Ball,Greg W. Chernoff,Nij Bhala,Subrata Ghosh,Elijah Dixon,Siew C. Ng,Gilaad G. Kaplan +10 more
TL;DR: In the 21st century, the incidence of appendicitis or appendectomy is high in newly industrialized countries in Asia, the Middle East, and Southern America, and Northern America, while in most Western countries the incidence is stable.