Initial laparoscopic appendectomy versus initial nonoperative management and interval appendectomy for perforated appendicitis with abscess: a prospective, randomized trial

Peter, Shawn D. St.; Aguayo, Pablo; Fraser, Jason D.; Keckler, Scott J.; Sharp, Susan W.; Leys, Charles M.; Murphy, John P.; Snyder, Charles L.; Sharp, Ronald J.; Andrews, Walter S.; Holcomb, George; Ostlie, Daniel J.

doi:10.1016/j.jpedsurg.2009.10.039

Cited by 170 publications

(113 citation statements)

References 15 publications

Supporting

Mentioning

101

Contrasting

Unclassified

Order By: Relevance

“…17 Non-surgical treatment also allowed a significantly shorter operative time in removing of a diminished inflammatory or normal appendix without adherence than in IA, reducing overall hospitalization time. 18 In line with the literature, presently there were significantly fewer complications and shorter operative time in nonsurgical treatment followed IA compared with in IS. As shown in Fig.…”

Section: Discussionsupporting

confidence: 72%

Therapeutic Consideration of Periappendiceal Abscess: an Evaluation of Non-surgical Treatment Followed by Minimally Invasive Interval Appendectomy

Yang

et al. 2017

J Minim Invasive Surg

View full text Add to dashboard Cite

Purpose: Periappendiceal abscess (PAA) is a severe complicated appendicitis with high morbidity. Non-surgical treatment followed by interval appendectomy (IA) is associated with lower complication rate compared with emergency surgery (ES) and minimally invasive surgery (MIS) can be done more often. The purpose of this study is to assess the incidence and factors predictive of complications of surgery for PAA and to evaluate the clinical effectiveness of IA as a treatment policy to increase MIS.Methods: Retrospectively, we reviewed 171 patients undergoing surgery for PAA between 2011 and 2016 at Ulsan University Hospital. The incidence and influence of different factors were assessed by univariate and multivariate analyses. Results:In 171 patients, 28 (16.4%) developed postoperative complications, which included; wound complications (7.6%), intra-abdominal abscess (4.1%) and ileus (2.9%). In both analyses, only ES was independently associated with postoperative complications; (Relative risk, 15.0; 95% Confidence interval, 2.4~92.5). Comparing the IA and ES groups revealed that operative time, complication rate, laparoscopic approach, postoperative hospitalization, postoperative antibiotic use and bowel resection rate were significantly different. The postoperative complication rate of patients with PAA in ES group was 28.7%, which was statistically higher than that of IA group (3.6%). Especially, MIS rate was more than 9-times greater in the IA group (98.8% vs. 10.3%, p<0.001). Although the IA group required additional hospitalization, there was no statistical difference between the two groups in total length of hospital stay. Conclusion:Morbidity was high for patients who had emergency surgery for PAA. ES was the only factor associated with postoperative morbidity. IA can reduce the postoperative complication rate and allowed MIS to be used more often as a useful treatment policy for PAA.

show abstract

Section: Discussionsupporting

confidence: 72%

Therapeutic Consideration of Periappendiceal Abscess: an Evaluation of Non-surgical Treatment Followed by Minimally Invasive Interval Appendectomy

Yang

et al. 2017

J Minim Invasive Surg

View full text Add to dashboard Cite

show abstract

“…Both groups were treated with once daily CM. There were no differences in length of total hospitalization, recurrent abscess rates, or overall charges between the two groups [13]. The length of stay in our study was longer than in other studies, this is because a very conservative discharge policy in our hospital permits discharge children after all the parameters return to normal.…”

Section: Discussioncontrasting

confidence: 55%

Single Daily Dosing of Ceftriaxone and Metronidazole is as Safe and Effective as Ampicillin, Gentamicin and Metronidazole for Non-operative Management of Complicated Appendicitis in Children

L¹

2013

Pediat Therapeut

View full text Add to dashboard Cite

Introduction: Perforated appendicitis very common abdominal emergency in children and nonoperative management with Ampicillin Gentamicin and Metronidazole (AGM) has shown good results. Recent data show that single daily dosing of Ceftriaxone and Metronidazole (CM) is as safe and effective as ampicillin gentamicin and clindamycin for treatment of perforated appendicitis after surgery in children. Treatment of complicated appendicitis in children with once daily CM can decrease the risk of in drug administration's mistake, require the patient to be connected to the IV line for short time only once a day, may cause less IV line infection and may cost less. The aim of this study was to compare the effectiveness, and safety of CM with the traditional triple antibiotic for conservative treatment of complicated appendicitis children.

show abstract

“…There are current data with much larger populations of patients promote operating on these children with shorter hospitalizations and equivalent complications to the conservative group. However, there are also several studies reporting of conservative treatment (with or without interval appendectomy) as an option to appendectomy, with similar results [14][15][16][17][18].…”

Section: Discussionmentioning

confidence: 79%

Evaluation of Different Treatments for Appendiceal Abscess in Children

Wersäll

Stenström²,

Arnbjörnsson³

et al. 2015

MOJS

View full text Add to dashboard Cite

Initial laparoscopic appendectomy versus initial nonoperative management and interval appendectomy for perforated appendicitis with abscess: a prospective, randomized trial

Cited by 170 publications

References 15 publications

Therapeutic Consideration of Periappendiceal Abscess: an Evaluation of Non-surgical Treatment Followed by Minimally Invasive Interval Appendectomy

Therapeutic Consideration of Periappendiceal Abscess: an Evaluation of Non-surgical Treatment Followed by Minimally Invasive Interval Appendectomy

Single Daily Dosing of Ceftriaxone and Metronidazole is as Safe and Effective as Ampicillin, Gentamicin and Metronidazole for Non-operative Management of Complicated Appendicitis in Children

Evaluation of Different Treatments for Appendiceal Abscess in Children

Contact Info

Product

Resources

About