Delayed Operative Management in Complicated Acute Appendicitis—Is Avoiding Extended Resection Worth the Wait ? Results from a Global Cohort Study

Leite, Rodrigo Moisés de Almeida; Souza, Alexandre Venâncio de; Bay, Camdem Phillip; Cauley, Christy E.; Bordeianou, Liliana; Goldstone, Rob; Francone, Todd D.; Kunitake, Hiroko; Ricciardi, Rocco

doi:10.1007/s11605-022-05311-2

Cited by 7 publications

(5 citation statements)

References 10 publications

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“…The concept of all-cause morbidity included any episode of return to the operating room, myocardial infarction, deep vein thrombosis, pneumonia, acute renal failure, cardiac arrest, urinary tract infection, wound disruption, pulmonary embolism, progression of renal failure and postoperative sepsis. This all-cause morbidity cohort has already been validated in previous studies [11,12] using data from the NSQIP and was included in our statistical analysis programme.…”

Section: Discussionmentioning

confidence: 99%

Bowel preparation for elective colectomy in Crohn's disease: results from a global cohort study using the NSQIP database

Callado,

de Almeida Leite,

Araujo

et al. 2024

Colorectal Disease

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AimThe role of bowel preparation before colectomy in Crohn's disease patients remains controversial. This retrospective analysis of a prospective cohort study aimed to investigate the clinical outcomes associated with mechanical and antibiotic colon preparation in patients diagnosed with Crohn's disease undergoing elective colectomy.MethodData were collected from the American College of Surgeons National Surgical Quality Improvement Program participant user files from 2016 to 2021. A total of 6244 patients with Crohn's disease who underwent elective colectomy were included. The patients were categorized into two groups: those who received combined colon preparation (mechanical and antibiotic) and those who did not receive any form of bowel preparation. The primary outcomes assessed were the rate of anastomotic leak and the occurrence of deep organ infection. Secondary outcomes included all‐cause short‐term mortality, clinical‐related morbidity, ostomy creation, unplanned reoperation, operative time, hospital length of stay and ileus.ResultsCombined colon preparation was associated with significantly reduced risks of anastomotic leak (relative risk 0.73, 95% CI 0.56–0.95, P = 0.021) and deep organ infection (relative risk 0.68, 95% CI 0.56–0.83, P < 0.001). Additionally, patients who underwent colon preparation had lower rates of ostomy creation, shorter hospital stays and a decreased incidence of ileus. However, there was no significant difference in all‐cause short‐term mortality or the need for unplanned reoperation between the two groups.ConclusionThis study shows that mechanical and antibiotic colon preparation may have clinical benefits for patients with Crohn's disease undergoing elective colectomy.

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Section: Discussionmentioning

confidence: 99%

Bowel preparation for elective colectomy in Crohn's disease: results from a global cohort study using the NSQIP database

Callado,

de Almeida Leite,

Araujo

et al. 2024

Colorectal Disease

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“…Leite, et al (2022) 12 showed the rate of extended resection appendectomy was significantly reduced with delayed operational management (risk ratio [RR] = 2.15, 95% confidence interval [CI] = 1.59 − 2.81, p < 0.001). There was no significant reduction in mortality linked with delayed operational management (RR = 2.17; 95% CI = 0.98-2.85, p = 0.05).…”

Section: Cross Sectional Study 611 Adult Patients Were Admitted With ...mentioning

confidence: 99%

Early Operative Management of Complicated Appendicitis Is Associated With Improved Surgical Outcomes in Adults: A Systematic Review

Hekmatyar

2023

JARMHS

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Introduction: Appendectomy is one of the most common surgeries in the US, with over 300,000 performed annually. In addition, 20% of adults may have complex appendicitis with extensive peritonitis, perforation, abscess, or phlegmon. In severe appendicitis patients, there is no unanimity on whether to operate or when. Statistics contradict each other. Non-operative care and radiologically guided percutaneous drainage have become prominent treatments. The aim: This article demonstrated an association between early surgical management of complicated appendicitis and enhanced surgical outcomes in adults. Methods: By comparing itself to the standards set by the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) 2020, this study was able to show that it met all of the requirements. So, the experts were able to make sure that the study was as up-to-date as it was possible to be. For this search approach, publications that came out between 2013 and 2023 were taken into account. Several different online reference sources, like Pubmed and SagePub, were used to do this. It was decided not to take into account review pieces, works that had already been published, or works that were only half done. Result: In the PubMed database, the results of our search brought up 68 articles, whereas the results of our search on SagePub brought up 51 articles. The results of the search conducted for the last year of 2013 yielded a total 19 articles for PubMed and 13 articles for SagePub. In the end, we compiled a total of 11 papers, 7 of which came from PubMed and 4 of which came from SagePub. We included three study that met the criteria. Conclusion: The benefits of immediate surgery for patients with complicated appendicitis include a reduction in hospitalization time, subsequent infections, and short-term mortality, according to research.

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“…The optimal treatment of CAA remains indeterminate (10) . CAA is associated with more risk of postoperative morbidity and mortality and has been delineated as a relative contraindication for LA.…”

Section: Introductionmentioning

confidence: 99%

Management of Complicated Acute Appendicitis in Adults: Laparoscopic versus Open Appendectomy

Baz¹,

Orban²,

Heggy³

2023

The Egyptian Journal of Hospital Medicine

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Background: Nowadays laparoscopic appendectomy (LA) is the management of choice for acute appendicitis (AA) in simple, uncomplicated cases. For complicated acute appendicitis (CAA), laparoscopic or conventional open appendectomy (OA) is still in debate.Objective: This study aimed to compare minimally invasive LA and traditional OA in CAA cases. Methods: In this study, 44 patients with CAA (22 for LA and 22 for OA) with 18 years of age or older were enrolled. It was conducted in General Surgery Department, Helwan University Hospital. Results:The operative time difference between the LA and OA groups was statistically significant (18.5 minutes shorter in the OA group, (p<0.001). The median length of hospital stay, return to normal activity, and patient satisfaction were significantly better in the LA group (p-values of 0.001, 0.00, and 0.14 respectively). The need for analgesics in the LA group was significantly lower than in the OA group. There were no detectable statistically significant findings concerning the occurrence of surgical findings, postoperative vomiting, postoperative ileus, wound infection, wound dehiscence, or postoperative intra-abdominal collection. Conclusions: Laparoscopic appendectomy management of CAA is feasible, safe, and has numerous advantages over the traditional open procedure in terms of reducing postoperative pain, requiring fewer analgesics, shortening the postoperative hospital stay, having a low incidence of postoperative infectious complications, and allowing a rapid return to daily activities with improved comfort and satisfaction.

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Delayed Operative Management in Complicated Acute Appendicitis—Is Avoiding Extended Resection Worth the Wait ? Results from a Global Cohort Study

Cited by 7 publications

References 10 publications

Bowel preparation for elective colectomy in Crohn's disease: results from a global cohort study using the NSQIP database

Bowel preparation for elective colectomy in Crohn's disease: results from a global cohort study using the NSQIP database

Early Operative Management of Complicated Appendicitis Is Associated With Improved Surgical Outcomes in Adults: A Systematic Review

Management of Complicated Acute Appendicitis in Adults: Laparoscopic versus Open Appendectomy

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