Efficacy of emergency laparoscopic appendectomy in treating complicated appendicitis for elderly patients

Wu, Tianchong; Lu, Qiao; Huang, Zhiyong; Liang, Xio-Hui

doi:10.15537/smj.2017.11.20469

Cited by 11 publications

(5 citation statements)

References 20 publications

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“…In Garg's study, 110 patients presented with CA and were operated on [20]. Similar results in favor of the laparoscopic method, also without statistical significance, are reported by Quezada (2.1% vs. 6.9%), Wu (5.4% vs. 20.3%), Mohamed (1.5% vs. 3.6%), Minutolo (1 vs. 3 patents) and Horvath (0.17% vs. 0.5%) [11,21,[22][23][24]. To the contrary, Lim reports a higher incidence of postoperative ileus in the laparoscopic group of patients presented exclusively with periappendicular abscess (16.7% vs. 8.3%; p = 0.028) [25].…”

Section: Discussionsupporting

confidence: 73%

Intra and Postoperative Advantages of Laparoscopy in the Treatment of Complicated Appendicitis

Nikolovski

Ulusoy²

2022

Prilozi

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Aim: To determine and define the advantages of the laparoscopic appendectomy in the treatment of complicated appendicitis by comparing it with the open appendectomy. Material and Methods: In this prospective interventional clinical study we compared the intraoperative data and the postoperative outcome of 77 patients presented with complicated appendicitis, operated with open and laparoscopic appendectomy within a period of 20 months. One surgeon performed all of the laparoscopic procedures and two other senior surgeons performed the open procedures. Results: Operative time was shorter in the laparoscopic group (p = 0.033). Conversion rate was 2.3%. Overall postoperative morbidity was 25.97%. There was one operative revision due to postoperative small bowel obstruction in the laparoscopic group. Appendicular stump leakage occurred in one patient in the open group. One intra-abdominal abscess occurred in the laparoscopic group (p = 0.38). Wound infection occurred only in the open group (p = 0.018). Length of stay was shorter in the laparoscopic group (p = 0.0052). One patient from the laparoscopic group was readmitted. Conclusions: Laparoscopy is a reliable method in the treatment of complicated appendicitis. It offers a shorter operative time, low conversion rate, an acceptable rate of major postoperative complications and a shorter length of stay.

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Section: Discussionsupporting

confidence: 73%

Intra and Postoperative Advantages of Laparoscopy in the Treatment of Complicated Appendicitis

Nikolovski

Ulusoy²

2022

Prilozi

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“…Only when the patient is reluctant to undergo surgery or the patient's general condition is poor, combined with multiple organ failure and other surgical contraindications can we consider conservative treatment. CA can result in a variety of potentially serious complications, such as peritonitis, abdominal abscess, and paralytic intestinal obstruction, [23] and its surgical treatment should be performed as early as possible and adequately prepared before the operation, in order to reduce intraoperative and postoperative complications, and reduce mortality. [13,24] Particularly for elderly patients, they have less physiologic reserves and poorer nutritional status, as well as more postoperative complications and mortality, when compared with younger patients.…”

Section: Discussionmentioning

confidence: 99%

“…[13,24] Particularly for elderly patients, they have less physiologic reserves and poorer nutritional status, as well as more postoperative complications and mortality, when compared with younger patients. [23] These fully illustrate the importance of immediately determining whether the patient has CA before the operation, in order to prevent the delayed timing of surgery due to complicated preoperative preparation or any affect on the prognosis of patients due to the choice non-surgical treatment. The study aims to identify whether it is CA as soon as possible after admission, so as to select the optimal treatment promptly, decrease unnecessary examinations and treatment, and reduce related complications.…”

Section: Discussionmentioning

confidence: 99%

Preoperative assessment of complicated appendicitis through stress reaction and clinical manifestations

Kang¹,

Li²,

Zheng³

et al. 2019

Medicine

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This study assessed the severity of the disease through the preoperative clinical manifestations and inflammatory reaction indicators of acute appendicitis, and established a score table to predict complicated appendicitis (CA). The clinical data of 238 patients with acute appendicitis in our hospital were retrospectively analyzed, which included 18 patients with acute simple appendicitis (7.6%), 170 patients with acute purulent appendicitis (72.0%), and 48 patients with acute gangrene and perforation (20.3%). The clinical manifestations and inflammatory reaction indicators were analyzed by univariate logistic regression. Multivariate logistic regression analysis was performed to screen out the independent risk factors of CA. The β coefficients of independent risk factors entering the multivariate model were assigned by rounding, and the total score was the sum of values of all factors. Finally, verification and analysis were performed for the predictive model, and the operating characteristic curve (ROC) curve was drawn. Then, the area under the curve (AUC) was compared with the THRIVE scale, and the Hosmer–Lemeshow method was used to evaluate whether the model fitted well. The multivariate logistic regression analysis of independent risk factors was performed, and the values were rounded to the variable assignment based on the β coefficient values. The plotted ROC and AUC was calculated as 0.857 ( P < .001). Using the Hosmer–Lemeshow method, the X 2 -value was 12.430, suggesting that the prediction model fitted well. The scoring system can quickly determine whether this is a CA, allowing for an earlier and correct diagnosis and treatment. Furthermore, the scoring system was convenient, economical, and affordable. Moreover, it is easy to popularized and promote.

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“…1. Twelve studies were finally included [15][16][17][18][19][20][21][22][23][24][25][26]. The basic characteristics of the studies were summarized in Table 1.…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

Laparoscopy versus open appendectomy for elderly patients, a meta-analysis and systematic review

Wang

Shao

et al. 2019

BMC Surg

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Background Appendicitis in elderly patients is associated with increased risk of postoperative complications. The choice between laparoscopy and open appendectomy remains controversial in treating elderly patients with appendicitis. Methods Comprehensive search of literature of MEDLINE, Embase, Cochrane Library and ClinicalTrials was done in January 2019. Studies compared laparoscopy and open appendectomy for elderly patients with appendicitis were screened and selected. Postoperative mortality, complications, wound infection, intra-abdominal abscess and operating time, length of hospital stay were extracted and analyzed. The Review Manage 5.3 was used for data analysis. Results Twelve studies with 126,237 patients in laparoscopy group and 213,201 patients in open group. Postoperative mortality was significantly lower following laparoscopy (OR, 0.33; 95% CI, 0.28 to 0.39). Postoperative complication and wound infection were reduced following laparoscopy ((OR, 0.65 95% CI, 0.62 to 0.67; OR,0.27, 95% CI, 0.22 to 0.32). Intra-abdominal abscess was similar between LA and OA (OR,0.44;95% CI, 0.19 to 1.03). Duration of surgery was longer following laparoscopy and length of hospital stay was shorter following laparoscopy (MD, 7.25, 95% CI, 3.13 to 11.36; MD,-2.72, 95% CI,-3.31 to − 2.13). Conclusions Not only laparoscopy is safe and feasible, but also it is related with decreased rates of mortality, post-operative morbidity and shorter hospitalization. Electronic supplementary material The online version of this article (10.1186/s12893-019-0515-7) contains supplementary material, which is available to authorized users.

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Efficacy of emergency laparoscopic appendectomy in treating complicated appendicitis for elderly patients

Cited by 11 publications

References 20 publications

Intra and Postoperative Advantages of Laparoscopy in the Treatment of Complicated Appendicitis

Intra and Postoperative Advantages of Laparoscopy in the Treatment of Complicated Appendicitis

Preoperative assessment of complicated appendicitis through stress reaction and clinical manifestations

Laparoscopy versus open appendectomy for elderly patients, a meta-analysis and systematic review

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