Appendicitis in the elderly: a change in the laparoscopic era

Paranjape, Charudutt; Dalia, Samir; Pan, James; Horattas, Mark C.

doi:10.1007/s00464-006-9097-4

Cited by 44 publications

(32 citation statements)

References 14 publications

(24 reference statements)

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“…Our operation time (57.98 minutes) was found to be shorter than most of the literature findings (78.3-88 minutes) (20,21,26). This was a result of lower laparoscopic appendectomy rates (6.6% only) of our study.…”

Section: Discussioncontrasting

confidence: 58%

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Retrospective cohort study of elderly patients with acute appendicitis

Arer¹,

Kus²,

Akkapulu³

et al. 2017

J Turgut Ozal Med Cent

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Aim: Appendicitis is the most common surgical cause of abdominal pain among the patients being admitted to Emergency department. Although it affects younger patients, its incidence increases in elderly as the population gets older. Higher perforation and complication rates have been reported in elderly patients. The aim of this study is to investigate appendicitis in patients older than 65 years. Material and Methods: A total of 61 patients with performed appendectomy older than 65 years age were included in this study. Laparoscopic and open appendectomies were included. Data were collected retrospectively. Patients were analyzed according to demograhic data, operative findings, complications and mortality. Results: Of 61 patients, 34 (55.7%) were male and 27 (44.3%) were female. The mean age was found to be 71.59 years. The average duration of symptoms were 3.2 days. Laparoscopic appendectomy was performed in only 4 (6.6%) patients. The mean hospital stay was found to be 3.89 days. Complications were found in 13 (21.3%) patients. Mortality was found to be 3.3%. Perforated appendicitis was found to be associated with physical findings, CRP level and hospital stay (p<0.05). Abdominal ultrasound has a sensitivity of 45.2% and specificity of 66.7% and computerized tomography has higher sensitivity (82.1%) and specificity (100%). Conclusion: Prompt diagnosis and treatment should be performed in the elderly patients with suspected appendicitis in order to prevent complications and mortality. Radiological modalities should be used to ensure accurate diagnosis of appendicitis in elderly patients.

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Section: Discussioncontrasting

confidence: 58%

“…This was a result of lower laparoscopic appendectomy rates (6.6% only) of our study. The mean length of hospital stay was found only 3.89 days that is also shorter than recent studies (20,21,26). We found that perforation of the appendix increases mortality rates and complications.…”

Section: Discussioncontrasting

confidence: 52%

Retrospective cohort study of elderly patients with acute appendicitis

Arer¹,

Kus²,

Akkapulu³

et al. 2017

J Turgut Ozal Med Cent

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“…Aufgrund von Komorbiditäten muss von einer signifikant erhöhten Morbidität und Letalität ausgegangen werden [7,9,22]. Gassel et al beschreiben eine 2,5fach erhöhte Morbidität und eine 12fach erhöhte Letalität im Rahmen der akuten Appendizitis bei Patienten über 50 Jahre [9].…”

Section: Tab 3 Appendektomie-komplikationen In Den Verschiedenen Altunclassified

“…Auch für Patienten mit Perforation ist die Laparoskopie mittlerweile die Methode der Wahl [15,20]. Für ältere Patienten zeigen derzeit mehrere Studien Vorteile der laparoskopischen gegenüber der konventionellen oder offenen Appendektomie [7,12,22,24]. So beschreiben Paranjape et al durch minimal-invasive Therapie der akuten Appendizitis bei älteren Patienten eine verringerte Morbidität und kürzere Liegezeiten [22].…”

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Altersappendizitis

Sülberg

Chromik

Kersting

et al. 2009

Chirurg

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“…It should also be noted that the rates of perforation are much higher in the elderly population and so many of the patients can also present with diffuse abdominal tenderness and peritonism (Korner et al, 1997;Hiu et al, 2002). The differential diagnosis for elderly patients presenting with abdominal pain is much broader and therefore when such a patient presents, especially with a non specific history, a computed tomography scan is the imaging modality of choice (Paranjape et al, 2007). In such circumstances, the presence of any other pathology can be assessed with a computed tomography scan and the appropriate management can be planned accordingly.…”

Section: Appendicitis At the Extremes Of Agementioning

confidence: 99%