Is Interval Appendectomy Necessary for Appendicular Phlegmon? A Prospective Study

Motie, Mohammad Reza; Ahmadabadi, Ali; Vejdani, Marjan; Rezapanah, Alireza; Rezaiyan, Majid Khadem; Shafiee, Mohammad Naser; Mahdiani, Armin

doi:10.1007/s12262-017-1644-9

Cited by 4 publications

(21 citation statements)

References 23 publications

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“…1 for the procedure of literature selection), of which 845 patients were treated surgically (group IO) and 756 patients were treated conservatively (group CM). A total of 4 randomized controlled studies (RCT) [20][21][22][23] were included, and 10 retrospective studies (RS) [24][25][26][27][28][29][30][31][32][33] were included. The literature information of major concern is shown in the following table (Table 1)…”

Section: Data Analysis and Processingmentioning

confidence: 99%

“…A total of 10 studies 21,22,[24][25][26][27]29,30,32,33 reported the occurrence of unplanned interventions during treatment in each group (Fig. 2.…”

Section: Unplanned Additional Interventionmentioning

confidence: 99%

“…3. D), among which there were 3 RCTS 20,21,23 , and 9 retrospective studies [24][25][26][27][28][29][30][31][32] . The summarized results showed that patients in the CM group had a lower incidence of incision infection than those in the IO group (OR = 2.733, 95%CI [1.243, 6.012], P = 0.01 < 0.05).…”

Section: Wound Infectionmentioning

confidence: 99%

“…The analysis results of operate time 27,28,32,33 ,overall complications 28,30 , intestinal fistula 21,25,26,28,29 , sepsis 23,25,26,31 , necrosis 23,25 , DVT 30,31 , pulmonary infection 30,31 are shown in Table 2.…”

Section: Other Outcomesmentioning

confidence: 99%

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What is the main problem in conservative management for complicated appendicitis? A systematic review

Zhang

Ren

Gao³

2020

Preprint

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Background: As a classification of appendicitis, complicated appendicitis has no standardized treatment for adults.Method: According to the related literature systematically searched on PubMed, Embase, Cochrane and Web of Science, we evaluated the efficacy of surgical treatment and conservative treatment for complicated appendicitis, especially focused on the outcomes about the length of stay, operation time, postoperative complications and unplanned additional intervention, in the literature. Result: A total of 14 studies were involved in the meta-analysis, including 845 patients in the immediate operation group (IO) and 756 patients in the conservative management group (CM). Compared with conservative treatment, the total hospitalization time was reduced by 1 day (WMD=-1.29, 95%CI [-2.42, -0.16], P=0.03<0.05). The incidence of unplanned additional intervention in patients undergoing emergency surgery is lower than that of conservative treatment (OR=0.18, 95%CI [0.11, 0.30], P<0.00001). Surgical patients are more likely to have complications such as wound infection (OR=2.41, 95%CI [1.08, 5.38], P=0.03<0.05) and intestinal obstruction (OR=4.14, 95%CI [2.21, 7.75], P<0.00001) than conservative patients. The incidence of abdominal abscess was lower than that of conservative treatment, and the difference was not statistically significant (OR=0.9, 95%CI [0.54, 1.47], P=0.66>0.05). Conclusion: Compared with conservative management patients, immediately operated patients have shorter hospitalization time and less unplanned intervention, which can significantly reduce the readmission opportunity of patients with complicated appendicitis and lighten the burden of follow-up and medical resource consumption.

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Section: Data Analysis and Processingmentioning

confidence: 99%

“…A total of 10 studies 21,22,[24][25][26][27]29,30,32,33 reported the occurrence of unplanned interventions during treatment in each group (Fig. 2.…”

Section: Unplanned Additional Interventionmentioning

confidence: 99%

Section: Wound Infectionmentioning

confidence: 99%

Section: Other Outcomesmentioning

confidence: 99%

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What is the main problem in conservative management for complicated appendicitis? A systematic review

Zhang

Ren

Gao³

2020

Preprint

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“…Dear Editor, We read with keen interest the article titled BIs Interval Appendectomy Necessary for Appendicular Phlegmon? A Prospective Study^by Motie et al published in 2017 issue of the Indian Journal of Surgery [1].…”

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confidence: 99%

Significant Points in Complicated Appendicitis

Kamer

Karaıslı

2017

Indian J Surg

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What is the main problem in the conservative management of complicated appendicitis? A meta-analysis

Zhang

Ren

Gao

2020

Preprint

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Background: As one of the classified groups of appendicitis, complicated appendicitis has no standardized treatment methods for adults.Method: The efficacy of surgical treatment and conservative treatment for complicated appendicitis was evaluated based on the literatures systematically searched on PubMed, Cochrane and Web of Science. A focus was given to important aspects, such as the outcomes of the length of stay, operation time, postoperative complications and unplanned additional interventions. Result: A total of 14 studies were involved in the meta-analysis, which included 845 patients in the immediate operation group (IO) and 756 patients in the conservative management group (CM). The total hospitalization time for patients with surgical treatment was decreased by 1 day (WMD= -1.29, 95% CI [-2.42, -0.16], P= 0.03< 0.05) compared to that of patients with conservative treatment. The incidence of unplanned additional interventions in patients who underwent emergency surgery is lower than that of patients with conservative treatment (OR=0.18, 95%CI [0.11, 0.30], P<0.00001). Compared to patients with conservative treatment, patients who received surgery are more likely to develop complications such as wound infection (OR=2.41, 95%CI [1.08, 5.38], P=0.03<0.05) and intestinal obstruction (OR=4.14, 95%CI [2.21, 7.75], P<0.00001). The incidence of abdominal abscess in patients with surgery treatment was lower than that of patients with conservative treatment, but the difference was not statistically significant (OR=0.9, 95%CI [0.54, 1.47], P=0.66>0.05). Conclusion: In treating complicated appendicitis, patients who received immediate operation, when compared to patients managed under conservative treatment, have shorter hospitalization time and less unplanned interventions; hence significantly reduce the likelihood of readmission. This can decrease the requirements for follow-up treatments and ultimately lower the consumption of medical resources.

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Is Interval Appendectomy Necessary for Appendicular Phlegmon? A Prospective Study

Cited by 4 publications

References 23 publications

What is the main problem in conservative management for complicated appendicitis? A systematic review

What is the main problem in conservative management for complicated appendicitis? A systematic review

Significant Points in Complicated Appendicitis

What is the main problem in the conservative management of complicated appendicitis? A meta-analysis

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