Long-term impacts of appendectomy associated with increased incidence of inflammatory bowel disease, infection, and colorectal cancer

Lee, Seohee; Jang, Eun Jin; Jo, Junwoo; Park, Soo‐Young; Ryu, Ho Geol

doi:10.1007/s00384-021-03886-x

Cited by 18 publications

(19 citation statements)

References 38 publications

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“…Those with underlying disease and comorbidities, such as malignancy disease, diabetes, chronic heart disease, congenital gastrointestinal disease and cerebral palsy, have a higher mortality rate 15 . Previous studies have mentioned about appendectomy may increase the risk of infection and sepsis in adults 10,17 . Our preliminary study revealed appendectomy confers a 1.29‐fold increased risk of developing subsequent sepsis regardless of sex or comorbidities in adults 18 .…”

Section: Introductionmentioning

confidence: 64%

“…The intestinal biofilms are considered as the first line of defence on the mucosa. The previous studies demonstrated that patients who underwent appendectomy may be at increased risk for sepsis 17,18 . Another study also mentioned about appendectomy will increase the risk of Salmonella infection 10 .…”

Section: Discussionmentioning

confidence: 99%

“…The previous studies demonstrated that patients who underwent appendectomy may be at increased risk for sepsis. 17,18 Another study also mentioned about appendectomy will increase the risk of Salmonella infection. 10 Once the appendix is removed, the stability and recovery capability of the biofilms are influenced, 24 and these changes affect the function of the gut mucosa layer and increase the risk of intestinal infections and systemic inflammation.…”

Section: Discussionmentioning

confidence: 99%

“…15 Previous studies have mentioned about appendectomy may increase the risk of infection and sepsis in adults. 10,17 Our preliminary study revealed appendectomy confers a 1.29-fold increased risk of developing subsequent sepsis regardless of sex or comorbidities in adults. 18 We speculated that appendectomy might affect the future risk of sepsis in children.…”

Section: Introductionmentioning

confidence: 86%

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Children with appendectomy have increased risk of future sepsis: Real‐world data in Taiwan

Liao

Lin

et al. 2021

Int J Clinical Practice

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Background Appendectomy is one of the most commonly performed surgeries worldwide. Sepsis is a major aetiology of morbidity and mortality in children. Our preliminary research revealed a positive correlation amongst appendectomy and future risk of sepsis in adults. However, to date, the relationship between appendectomy and future risk of sepsis in children remains unknown. The aim of this research was to investigate the relationship between appendectomy and the hazard of future sepsis in children. Methods We applied a nationwide population‐based cohort to assess whether children who received appendectomy were at increased risk of subsequent sepsis. Overall, 57 261 subjects aged below 18 undergoing appendectomy as appendectomy group and 57 261 matched controls were identified as a non‐appendectomy group from the National Health Insurance Research Database in Taiwan. We use propensity score analysis to match the age, sex, urbanisation level and parental occupation at the ratio to 1:1. Multiple Cox regression and stratified analyses were used to appraise the adjusted hazard ratio (aHR) for developing sepsis in children. Results Children who received appendectomy had a 2.38 times higher risk (aHR: 2.38; 95% confidence interval [CI] = 1.98, 2.87) of developing sepsis than those who did not, and the risk was higher in all age groups (aHR: 2.98, 95% CI = 1.84, 4.83; aHR: 2.45, 95% CI = 1.08, 2.05; aHR: 2.18, 95% CI = 1.70, 2.80 in children aged <6, 7‐12 and 13‐18 years, respectively). Patients with <1‐year follow‐up showed a 4.53‐fold risk of sepsis in the appendectomy cohort (aHR: 4.53, 95% CI = 2.80, 7.35). Patients with 1‐4 and ≥5 years’ follow‐up showed a 2.19‐ and 1.94‐times risk of sepsis (aHR: 2.19, 95% CI = 1.61, 2.97; aHR: 1.94, 95% CI = 1.48, 2.56 in 1‐4 and >5 years, respectively). Conclusion Appendectomy was correlative to a 2.38‐fold increased future sepsis risk in children, and the risk in all age groups was higher. More studies to interpret the possible biological mechanisms of the associations amongst sepsis and appendectomy are warranted.

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Section: Introductionmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 86%

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Children with appendectomy have increased risk of future sepsis: Real‐world data in Taiwan

Liao

Lin

et al. 2021

Int J Clinical Practice

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“…There has been reported that appendectomy increases the risk of CRC ( 22 ). One theory of its possible mechanism is that the appendix is essential to the development of lymphatic tissues in the intestinal tract and a lack of such tissues hinders inflammation and reduces disruptive self-reactions in the large intestine.…”

Section: Discussionmentioning

confidence: 99%

Construction and assessment of a joint prediction model and nomogram for colorectal cancer

Chen¹,

Ma²,

Dong³

et al. 2022

J Gastrointest Oncol

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Background: Colorectal cancer (CRC) is one of the most common tumors in the digestive system, and all its risk factors are not yet known. It is important to identify valuable clinical indicators to predict the risk of CRC.Methods: A total of 227 participants, comprising 162 healthy adults and 65 patients diagnosed with CRC at Tianjin Hospital from January 2017 to March 2022, were included in this study. Electrochemiluminescence was adopted to test the expression levels of carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA199). Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for CRC, and a joint prediction model was then constructed. A nomogram was prepared, and the model was later assessed using the receiver operating characteristic curve and calibration curve. Results:The univariate analysis showed that there were statistically significant differences between the two groups in terms of smoking (χ 2 =8.67), fecal occult blood (χ 2 =119.41), Helicobacter pylori (H. pylori) infection (χ 2 =30.87), a history of appendectomy (χ 2 =5.47), serum total bile acid levels (t=19.80), serum CEA levels (t=37.82), serum CA199 levels (t=6.82), and serum ferritin levels (t=54.31) (all P<0.05). The multiple logistic regression analysis showed that smoking, fecal occult blood, H. pylori infection, a history of appendectomy, serum CEA levels, and serum CA199 levels were independent risk factors for CRC (all P<0.05). Based on the above findings, a joint prediction model was constructed, and the area under the receiver operator characteristic (ROC) curve of the model was 0.842. A nomogram and calibration curve was drawn, and the internal validation results indicated that the model had good diagnostic value.Conclusions: Smoking, fecal occult blood, H. pylori infection, a history of appendectomy, serum CEA levels, and serum CA199 levels are independent risk factors for CRC, and the prediction model based on these factors had good predictive ability.

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Appendix removal affects the subsequent cancer risk in Asian adults: A territory-wide population-based cohort study

Hu,

Guo,

Lau

et al. 2024

Cancer Letters

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Long-term impacts of appendectomy associated with increased incidence of inflammatory bowel disease, infection, and colorectal cancer

Cited by 18 publications

References 38 publications

Children with appendectomy have increased risk of future sepsis: Real‐world data in Taiwan

Children with appendectomy have increased risk of future sepsis: Real‐world data in Taiwan

Construction and assessment of a joint prediction model and nomogram for colorectal cancer

Appendix removal affects the subsequent cancer risk in Asian adults: A territory-wide population-based cohort study

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