Communication and management of incidental pathology in 1,214 consecutive appendicectomies; a cohort study

Kinnear, Ned; Heijkoop, Bridget; Bramwell, Eliza; Frazzetto, Alannah; Noll, Amy; Patel, Prajay; Hennessey, Derek; Otto, Greg; Dobbins, Christopher; Sammour, Tarik; Moore, James

doi:10.1016/j.ijsu.2019.10.025

Cited by 10 publications

(5 citation statements)

References 46 publications

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“…Time to the operating room has been described as a key benefit of the ASU model and is commonly implicated in superior patient outcomes 3,6 . The main reason behind reducing time to theatre is to improve overall clinical outcomes and patient care; prompt treatment of emergency cases leads to lower complication rates, lower risk of perforation and shorter hospital admissions 11 .…”

Section: Discussionmentioning

confidence: 99%

“…In addition, a retrospective Australian study conducted by Poh et al ., who compared the outcomes of 539 patients undergoing appendicectomy, showed that the ASU model had a significant decrease in overnight operations compared to the traditional model 5 . Likewise, another large Australian study of 1214 patients by Kinnear et al ., which compared pre‐ and post‐ASU model introduction, reported a significantly lower median time from the emergency department to the start of surgery and shorter median length of stay 6 …”

Section: Introductionmentioning

confidence: 99%

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Comparative analysis of emergency general surgery on‐call structure and its impact on emergency appendicectomy outcomes

Gounder

Dissanayake

Burstow

et al. 2021

ANZ Journal of Surgery

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Background In Australia, there has been a shift from the traditional ‘on‐call’ surgical model to the ‘acute surgical unit’ (ASU) model to improve outcomes in acute general surgery. Using emergency appendicectomy as a standardized procedure, we aimed to identify the different patterns of care between these on‐call structures by comparing two metropolitan district hospitals; one that employs a traditional on‐call model and the other, which employ the ASU model. Methods Data on consecutive patients undergoing emergency appendectomies at the two hospitals (traditional and ASU model) between July 2018 and December 2018 were retrieved for retrospective review. Patient factors, preoperative factors, operative factors and post‐operative outcomes were collected and tabulated for comparative analysis between the traditional versus ASU model of care. Results Univariate analysis demonstrated that there were a greater proportion of consultant‐led cases (P < 0.001), a shorter time to theatre (P = 0.047) and a greater number of out‐of‐hours operations (P < 0.001) in the ASU model compared to the traditional model. A larger proportion of patients from the traditional model underwent a computed tomography scan as part of their diagnostic workup compared to the ASU model (P < 0.001). There was no difference in negative appendicectomy rates, intraoperative conversion rates, post‐operative complication rates or mean lengths of hospital stay between the two on‐call models. Conclusion The ASU and traditional on‐call model appears to achieve equivalent care outcomes for patients with acute appendicitis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparative analysis of emergency general surgery on‐call structure and its impact on emergency appendicectomy outcomes

Gounder

Dissanayake

Burstow

et al. 2021

ANZ Journal of Surgery

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“…Malignancy is an important, albeit rare, cause of acute appendicitis in older adults [ 10 , 11 ]. Studies have found neoplasms in up to 2.5% appendectomy specimens [ 12 , 13 ], with only about 0.1% being metastatic [ 14 , 15 ]. Neuroendocrine tumors are the most common primary appendiceal neoplasms associated with acute appendicitis [ 11 , 12 , 14 ].…”

Section: Discussionmentioning

confidence: 99%

“…Neuroendocrine tumors are the most common primary appendiceal neoplasms associated with acute appendicitis [ 11 , 12 , 14 ]. Other primary appendiceal neoplasms identified in the causation of acute appendicitis include adenomas (sessile serrated adenoma, tubular adenoma, and villous adenoma), adenocarcinoma, and low-grade and high-grade appendiceal mucinous neoplasms [ 11 , 12 , 15 ].…”

Section: Discussionmentioning

confidence: 99%

An Unusual Case of Acute Appendicitis due to Metastatic Prostatic Adenocarcinoma

Numbere

Dunn

Huber

2020

Case Reports in Pathology

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Acute appendicitis is a common surgical emergency in older adults. In the elderly, like in younger cohorts, acute appendicitis most commonly arises without neoplastic underpinnings. However, the occurrence of acute appendicitis in a patient with a concurrent abdominopelvic malignancy should trigger suspicion for the possibility of a metastatic appendiceal neoplasm. We present the case of a 66-year-old man with a background of a biochemically recurrent prostatic adenocarcinoma who presented to the emergency department with acute appendicitis. Histopathologic examination of the resected appendix revealed an unexpected metastatic spread from his prostatic adenocarcinoma.

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“…Endometriosis of the appendix has been reported as a rare condition [6], but it 2 of 16 may be prevalent depending on the population [7]. In general, the prevalence of appendiceal endometriosis in women with endometriosis and those with deep endometriosis ranges from 0.05% to 1.69% [8][9][10][11] and 2.6% to 13.2%, respectively [12,13]. Endometriosis of the appendix may be asymptomatic or may cause symptoms of acute and chronic appendicitis [14,15].…”

Section: Introductionmentioning

confidence: 99%

Appendiceal Endometriosis: A Comprehensive Review of the Literature

et al. 2023

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Objective: the purpose of this review was to evaluate the prevalence of appendiceal endometriosis and the safety of concomitant appendectomy in women with endometriosis or pelvic pain. Materials and Methods: We searched the electronic databases Medline (PubMed), Scopus, Embase, and Web of Science (WOS). The search was not subject to any limitation in terms of time or method. The primary research question was: what is the prevalence of appendiceal endometriosis? The secondary research question was: is it safe to perform appendectomy during surgery for endometriosis? Publications that reported data about appendiceal endometriosis or appendectomy in women with endometriosis were reviewed regarding the inclusion criteria. Results: We found 1418 records. After review and screening, we included 75 studies published between 1975 and 2021. With regard to the first question of the review, we found 65 eligible studies and divided these into the following two categories: (a) endometriosis of the appendix presenting as acute appendicitis, and (b) endometriosis of the appendix as an incidental finding in gynecological surgery. Forty-four case reports described appendiceal endometriosis in women who were admitted for the treatment of pain in the right-sided lower abdomen. Endometriosis of the appendix was observed in 2.67% (range, 0.36–23%) of women who were admitted due to acute appendicitis. In addition, appendiceal endometriosis was an incidental finding during gynecological surgery in 7.23% of cases (range, 1–44.3%). With regard to the second question of the review, which was the safety of appendectomy in women with endometriosis or pelvic pain, we found 11 eligible studies. Reviewed cases had no significant intraoperative or follow-up complications during the 12 weeks. Conclusion: Based on the reviewed studies, coincidental appendectomy appears reasonably safe and was associated with no complications in the cases reviewed for the present report.

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Communication and management of incidental pathology in 1,214 consecutive appendicectomies; a cohort study

Cited by 10 publications

References 46 publications

Comparative analysis of emergency general surgery on‐call structure and its impact on emergency appendicectomy outcomes

Comparative analysis of emergency general surgery on‐call structure and its impact on emergency appendicectomy outcomes

An Unusual Case of Acute Appendicitis due to Metastatic Prostatic Adenocarcinoma

Appendiceal Endometriosis: A Comprehensive Review of the Literature

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