Objective:To assess the therapeutic effects of emergency laparoscopic appendectomy (LA) in treating complicated appendicitis (CA) for elderly patients (defined as age >65 years).Methods:We conducted a retrospective study of 115 elderly patients with CA who underwent surgical therapy in the Affiliated Huizhou Hospital of Sun Yat-Sun University, Huizhou, Guangdong Province, China between September 2014 and August 2016. Of these, 59 patients consented to open appendectomy (OA), and LA was performed in the other 56 patients. The perioperative and follow-up variables of the 2 groups were analyzed.Results:The operative time in the LA group was longer than the OA group (LA: 70.5±16.0 min versus [vs.] OA: 59.3±12.0 min, p<0.001). The LA group had lower chances of incision infections (LA: 8.9% vs. OA: 28.8 %, p=0.007) and shorter hospital stay (LA: 6.1± 2.5 days vs. OA: 9.6±3.5 days, p<0.001). Return to soft diet (LA: 1.4 ± 0.8 days vs. OA: 3.0 ± 1.6 days, p<0.001) and time to out of bed (LA: 1.3±0.5 days vs. OA: 2.5±0.9 days, p<0.001) was faster in the LA group. The incidence of complications and 30-day readmission rate in the LA group was much lower than the OA group.Conclusion:Emergency LA in treating elderly patients with CA has the advantages of less trauma, definite curative effect, low complication rates, and fast recovery when compared with OA.
The EEL is a clinically safe and necessary choice for early diagnosis and treatment in IOH. EEL may improve the curative effect of IOH significantly.
Aim Acute appendicitis is one of the most common paediatric surgical emergencies. Prompt diagnosis and interventions reduce the risk of perforation and prevents complications. The aim of the audit was to determine the appropriateness of operative intervention and to improve patient care by implementing changes. We assessed several performance indicators including the percentage of appendicectomy performed within 12 hours of decision to operate, the percentage of negative appendicectomy and the 30 days re-admission rate. Method All consecutive paediatric patients who had appendicectomy in our district general hospital from Jan 2017 to 2019 were included in the initial audit. For re-audit, we collected data from July 2019 to March 2020. Patients were identified from the theatre system and ward notes, theatre charts and biochemistry and histology results were collected from the electronic patient records. Results A total of 193 patients were included in the initial audit. Results showed that 52.8% of patients were reviewed by a consultant prior to surgery, 92% of patients had surgery within 12 hours of the decision to operate. The rate of negative appendicectomy rate was 25%. Conclusions Following this audit, several changes have been implemented including improving consultant review of paediatric patients, increasing imaging done by radiologists for paediatric patient. Re-audit showed that 86.7% of patients were reviewed by a consultant preoperatively. Negative appendicectomy rate remained the same at 24.4%. Admissions within 30 days of discharge improved from 13.8% in the initial audit to 11.5% in re-audit.
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