Laparoscopic appendectomy: Which factors are predictors of conversion? A high-volume prospective cohort study

Antonacci, Nicola; Ricci, Claudio; Taffurelli, Giovanni; Monari, Francesco; Governatore, Marco Del; Caira, A; Leone, Alessandro; Cervellera, Maurizio; Minni, Francesco; Cola, Bruno

doi:10.1016/j.ijsu.2015.06.089

Cited by 43 publications

(43 citation statements)

References 8 publications

(5 reference statements)

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“…Our classification also brings attention to the hepatic location (type VII) of the VA, which although not common (presents in around 2.5% of cases), may have great clinical implications. The hepatic location of the VA has been linked to an atypical presentation of appendicitis (mimicking cholecystitis) and is related to an increased number of intra‐operative difficulties (Antonacci et al ; Aneiros Castro et al ). Taking all of those facts into consideration, the position of the VA may be used as an important element of clinical scoring of patients with suspected or confirmed acute appendicitis as it significantly affects pre‐operative and intra‐operative course of the disease.…”

Section: Discussionmentioning

confidence: 99%

Variations and morphometric features of the vermiform appendix: A systematic review and meta‐analysis of 114,080 subjects with clinical implications

et al. 2019

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Determining the true and indisputable data regarding the vermiform appendix (VA) morphology is of a great clinical interest. The aim of this study was to provide the best evidence‐based anatomical overview of the variations in location and size of VA using a systematic and meta‐analytical approach. A systematic review with meta‐analysis was performed of studies reporting variants of the location and morphometric data regarding the VA. The MEDLINE/PubMed, ScienceDirect, EMBASE, BIOSIS, SciELO, and Web of Science databases were thoroughly searched throughout June 2018. The reported locations of the body of the VA were re‐classified into a new, standardized classification system divided into nine categories. The AQUA tool was used to assess the quality of included studies. The research was conducted following PRISMA guidelines and registered at PROPSERO database. Our meta‐analysis included 242 studies (n = 114,080). Overall, the VA was most commonly found in the retrocecal location (32.1%, 95%CI: 29.2–35.1), followed by the pelvic (28.5%, 95%CI: 26.7–30.4) and ileal (14.5%, 95%CI: 11.8–17.7) locations. Subjects without known appendiceal pathologies had significantly smaller VA outer diameters (5.84 mm, 95%CI: 5.68–5.99) than patients diagnosed with acute appendicitis (10.64 mm, 95%CI: 10.14–11.15). The overall pooled mean length of the VA was 80.29 mm (95%CI: 76.68–83.89). Significant differences were found in size of the VA between imaging modalities. The results obtained from this evidence‐based anatomy study will improve the clinical understanding of the VA anatomy, which in turn will have major implications for clinical practice. Clin. Anat. 32:85–98, 2019. © 2019 Wiley Periodicals, Inc.

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Section: Discussionmentioning

confidence: 99%

Variations and morphometric features of the vermiform appendix: A systematic review and meta‐analysis of 114,080 subjects with clinical implications

et al. 2019

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“…This number was significantly higher than recent published work from Kim et al [5], where a conversion rate of 11.8% was seen in cases of complicated appendicitis. In similar study examining causes of conversion to laparotomy in both simple and complicated appendicitis, a conversion rate of 7.9 was noted [6]. In an effort to better understand this high conversion rate, we looked at the preoperative characteristics of our patient population [7].…”

Section: Discussionmentioning

confidence: 99%

Predictors of Failed Laparoscopic Appendectomy in Perforated Appendicitis

Martin¹,

Wert²,

Lyon

et al. 2018

JACS

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A recent internal review of a community-based hospital system revealed a 19.19% rate of conversion from a laparoscopic appendectomy to an open procedure. This study examined the preoperative risk factors for failed laparoscopic appendectomy requiring a conversion to a laparotomy. Methods: A total of 198 patients presented with perforated appendicitis. Perforation was defined as a computed tomography (CT) scan interpretation, pathology findings, or surgical findings. Of these patients, 161 underwent a laparoscopic appendectomy or laparoscopy converted to an open procedure. The preoperative risk factors in the two groups were compared through a retrospective chart review. Results: Through multivariant analysis, age greater than 45 was the greatest risk factor for the need to convert to an open procedure with an odds ratio (OR) of 3.51. A CT scan read of perforation was associated with a significant 2.65 OR. The C-reactive protein was 19.82 mg/L in the failed laparoscopic cases and 9.96 mg/L in the laparoscopic cases. Conclusion: Patients older than 45 years old with a CT radiologist's read of a perforation in multivariant analysis have an increased risk of failed laparoscopic surgery requiring conversion to open surgery.

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“…7 Usually, the surgery for perforated appendicitis is more difficult than that for simple and gangrenous appendicitis and, sometimes, there are cases requiring conversion to open surgery or CLA. 9 There have been several reports about the results of laparoscopic appendectomy for complicated appendicitis. Compared to the open appendectomy, a lower surgical site infection rate, a comparable intra-abdominal infection rate, and a shorter hospital stay were observed in the CLA for complicated appendicitis.…”

Section: Discussionmentioning

confidence: 99%

Feasibility of Single Port Laparoscopic Surgery in Patients with Perforated Appendicitis

Choi¹,

Byun²,

Hwang³

et al. 2016

J Minim Invasive Surg

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Acute appendicitis is a common disease which requires emergency surgery. Since its first introduction by Semm in 1983, 1 laparoscopic appendectomy has been conducted more frequently than the open appendectomy. This has been due to numerous advantages of laparoscopic appendectomy, such as less postoperative pain, faster recovery, lower wound complication, and shorter length of hospital stay. 2-4 As minimal invasive surgical techniques and instruments have gradually developed, the use of single-port laparoscopic appendectomy (SPLA) has become more frequent and numerous studies addressed the advantages and disadvantages of SPLA as compared to conventional laparoscopic appendectomy (CLA). 5,6 However, SPLA has some technical limits, such as restricted vision and reduced degree of freedom in using laparoscopic instruments. 7 Therefore, this study aims to investigate feasibility, safety, and cosmetic result of SPLA in treating perforated appendicitis, which is a more difficult procedure than SPLA for simple and gangrenous appendicitis.

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Laparoscopic appendectomy: Which factors are predictors of conversion? A high-volume prospective cohort study

Cited by 43 publications

References 8 publications

Variations and morphometric features of the vermiform appendix: A systematic review and meta‐analysis of 114,080 subjects with clinical implications

Variations and morphometric features of the vermiform appendix: A systematic review and meta‐analysis of 114,080 subjects with clinical implications

Predictors of Failed Laparoscopic Appendectomy in Perforated Appendicitis

Feasibility of Single Port Laparoscopic Surgery in Patients with Perforated Appendicitis

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