Laparoscopic versus open approach in the management of appendicitis complicated exclusively with peritonitis: A single center experience

Quezada, Felipe; Quezada, Nicolás; Mejía, Ricardo; Brañes, Alejandro; Padilla, Oslando; Jarufe, Nicolás; Pimentel, Fernando

doi:10.1016/j.ijsu.2014.11.027

Cited by 31 publications

(35 citation statements)

References 19 publications

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“…In a randomized clinical study conducted by Taguchi et al 13 four cases of stump leakage were found in the closed appendiceal stump with the technique of bipolar endocoagulation in CA cases. The operative time in the studies by Taguchi et al 13 and Quezada et al 28 was longer than in our study. In our study, patients with an abscess had a longer operative time, which may explain the presence of appendiceal inflammatory processes, aspiration of abscess formation, irrigation, and a more difficult operation.…”

Section: Discussioncontrasting

confidence: 65%

“…12,13,14,15,16,17 It may be reasonable to assume that the presence and proliferation of peritonitis may be a risk factor for POIAA, and therefore, necrotic perforated appendicitis in the intraabdominal space may have a lower risk of POIAA than cases complicated by peritonitis. 3,12,14,16,17,28 Another issue discussed is that abundant irrigation of the abdominal cavity with 0.9% saline solution is shown as one of the causes of abscess development. 3 In a clinical study performed by Katkhouda et al 17 the examination of the Douglas, irrigation, aspiration and the use of endobags removed abscesses and necrotic fragments from cavities and reduced the frequency of POIAA from 2.4% to 0.4%.…”

Section: Discussionmentioning

confidence: 99%

“…4,5,16,17,18,26,28 Laparotomy causes adhesions, local perforation, diffuse peritonitis, appendix base necrosis, retrocecal position, bleeding, appendicular tumor and inability to identify iatrogenic lesions. 27,28,29,30 In our study, none of the 71 patients required laparotomy. Four patients with developed paralytic ileus responded to medical treatment.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Comparison of Laparoscopic Embedding Technique and Other Techniques for Appendiceal Stump Closure

Güneş¹,

Gemici²,

Dönmez³

2019

tjcd

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Amaç: Akut apandisit tüm dünyada en sık görülen cerrahi acil durumdur. Laparoskopik apendektomi akut apandisit ameliyatlarında yaygın olarak kullanılmaktadır. Apendiks güdüğünün kapatılmasında birçok teknik kullanılmıştır. Çalışmamızda, laparoskopik gömme tekniğinin etkinlik ve güvenilirliğini araştırmayı amaçladık. Yöntem: Temmuz 2017-Aralık 2018 tarihleri arasında akut apandisit için apendiks güdüğünün kapatılmasında laparoskopik gömme yöntemi kullanılan hastalar dahil edildi. Fizik muayene, laboratuvar testleri, ultrason ve bilgisayarlı tomografi muayenesi ile akut apandisit tanısı kondu. Mezoapendiksin diseksiyonu bir LigaSure cihazı ile yapıldı ve daha sonra apendiks radiks intrakorporeal düğümleme tekniği ile bağlandı ve bir keseli dikiş ipliği ile çekuma ters çevrildi. Hastalar yaş, cinsiyet, vücut kitle indeksi (VKİ), dönüşüm oranı, ameliyat süresi, ameliyat sonrası komplikasyonlar ve hastanede kalış süresi açısından incelendi. Bulgular: Yaş ortalaması 34,81±1,88 idi; ortalama VKİ 27,51±5,44 kg/m 2 idi. Ortalama ameliyat süresi 61,93±17,67 dk idi. Otuz iki hastada komplike apandisit, 39 hastada komplike olmayan apandisit vardı. Komplike olmayan apandisitli hastalarda, 4 hastada cerrahi alan enfeksiyonu ve 2 hastada ileus gelişti; komplike apandisit olgularında 2 hastada ileus, 3 hastada cerrahi alan enfeksiyonu gelişti. Ortalama hastanede kalış süresi 38,92±25,90 saat idi. Sonuç: Laparoskopik gömme tekniği akut apandisit için kolay, basit, güvenli, hızlı ve etkilidir ve komplike apandisitte appendiks tabanının güvenliğinde tercih edilen yöntem olacaktır. Anahtar Kelimeler: Laparoskopik apendektomi, akut apandisit, apendiks güdüğü Aim: Acute appendicitis is the most common surgical emergency worldwide. Laparoscopic appendectomyis widely used in acute appendicitis. In our study, we aimed to investigate the efficacy and safety of laparoscopic embedding technique. Method: Patients who underwent laparoscopic embedding technique for appendiceal stump between July 2017 and December 2018 were included in the study. Acute appendicitis was diagnosed by physical examination, laboratory tests, ultrasound and computed tomography scan. Dissection of the mesoappendix was performed with a bipolar tissue sealing system, and then the appendix radix was ligated using intracorporeal knotting technique and inverted into the cecum with a suture. The patients were evaluated in terms of age, gender, body mass index (BMI), rate of conversion, operative time, postoperative complications and length of hospital stay. Results: The mean age was 34.81±1.88 years and the mean BMI was 27.51±5.44 kg/m 2. The mean operative time was 61.93±17.67 minutes. Thirtytwo patients had complicated appendicitis and 39 patients had uncomplicated appendicitis. In patients with uncomplicated appendicitis, four patients developed surgical site infection and two patients had ileus; whereas two patients developed ileus and three patients developed surgical site infection in complicated appendicitis cases. The mean length of hospital stay was 38.92±25.90 ho...

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Section: Discussioncontrasting

confidence: 65%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Comparison of Laparoscopic Embedding Technique and Other Techniques for Appendiceal Stump Closure

Güneş¹,

Gemici²,

Dönmez³

2019

tjcd

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“…[10,11] Moreover, LA has been shown to be safer in complicated AA than in open surgery; therefore, its use in the emergency setting is rising. [12][13][14][15][16] While challenging, discrimination between uncomplicated and complicated AA is clinically relevant as outcomes vary, with complicated cases faring worse. [17] Additionally, patients with uncomplicated AA may be successfully treated with antibiotics, in comparison to complicated cases, which practically always require an appendectomy.…”

Section: Introductionmentioning

confidence: 99%

Complicated appendicitis: risk factors and outcomes of laparoscopic appendectomy – results from Pol-LA (Polish Laparoscopic Appendectomy) multicenter large cohort study.

Pędziwiatr

Lasek

Wysocki

et al. 2018

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: Preoperative classification of complicated and uncomplicated appendicitis (AA) is challenging. However, the differences in surgical outcomes necessitate the establishment of risk factors in developing, complicated AA. This study was an analysis of the clinical outcomes of laparoscopic appendectomies (LA), as well as preoperative risk factors for the development of complicated AA. METHODS: The data of 618 patients who underwent LA in 18 surgical units across Poland and Germany were collected in an online web-based database created by the Polish Videosurgery Society. The surgical outcomes of patients with complicated and uncomplicated appendicitis were compared. Uni-and multivariate logistic regression models were used to establish risk factors for the development of complicated appendicitis. RESULTS: In all, 1269 (27.5%) patients underwent LA for complicated appendicitis (Group 1) and 3349 (72.5%) for uncomplicated appendicitis (Group 2). The conversion rate, number of intra-operative adverse events, re-intervention rate, postoperative complications, and readmission rate was greater in Group 1. The preoperative risk factors associated with complicated appendicitis were:

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“…The advantages of this method include decreased wound infections, a shorter postoperative recovery time, reduced time to return to normal activities, and a reduced need for postoperative analgesia (7)(8)(9). Open and laparoscopic appendicitis studies exist in the literature, but few have investigated the neuroendocrine response (10)(11)(12).…”

Section: Discussionmentioning

confidence: 99%

Comparison of Neuroendocrine Responses in Open and Laparoscopic Appendectomies in Children: A Randomized Controlled Trial

Salkaya¹,

Özbağrıaçık²,

Akay³

et al. 2016

jpr

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Laparoscopic versus open approach in the management of appendicitis complicated exclusively with peritonitis: A single center experience

Abstract: Both approaches showed no differences in complications in the management of appendicitis complicated exclusively with peritonitis. In our experience, laparoscopic appendectomy is a safe approach in cases of appendicitis complicated exclusively with peritonitis.

Cited by 31 publications

References 19 publications

Comparison of Laparoscopic Embedding Technique and Other Techniques for Appendiceal Stump Closure

Comparison of Laparoscopic Embedding Technique and Other Techniques for Appendiceal Stump Closure

Complicated appendicitis: risk factors and outcomes of laparoscopic appendectomy – results from Pol-LA (Polish Laparoscopic Appendectomy) multicenter large cohort study.

Comparison of Neuroendocrine Responses in Open and Laparoscopic Appendectomies in Children: A Randomized Controlled Trial

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