Preoperative predictors of extended resection in patients with complicated acute appendicitis undergoing surgery

Waki, Yuhei; Hotchi, Masanori; Utsunomiya, Daichi; Inoue, Takeshi; Obatake, Masayoshi

doi:10.2152/jmi.68.334

Cited by 6 publications

(5 citation statements)

References 24 publications

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“…12-14 Revision appendectomy may require ileocecectomy or right hemicolectomy depending on inflammation extent, raising concerns about prolonged operative duration, increased blood loss, and postoperative hospitalization. 15 Our case illustrates a recurrence of appendicitis due to a fecalith despite a short stump length. Initial surgical intervention likely failed to extract the fecalith.…”

Section: Discussionmentioning

confidence: 78%

SpyGlass/Cholangioscope-Assisted Colonoscopic Removal of Appendicolith as a Nonsurgical Alternative for Stump Appendicitis Management

Sudan,

Julka,

Patel

2024

ACG Case Rep J

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An appendicolith is a calcified mass which can obstruct the appendix often leading to recurrent appendicitis. Failure to extract fecalith at the time of appendectomy can lead to recurrent inflammation in the appendiceal stump. We describe a 28-year-old man with stump appendicitis due to a retained fecalith postappendectomy. Our approach, akin to interval appendectomy, combines antibiotics and endoscopic intervention postinfection resolution. This case highlights the feasibility and safety of endoscopic management, offering a nonsurgical alternative to prevent the morbidity associated with revision surgery. Further exploration of nonsurgical modalities is warranted to optimize patient outcomes.

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Section: Discussionmentioning

confidence: 78%

SpyGlass/Cholangioscope-Assisted Colonoscopic Removal of Appendicolith as a Nonsurgical Alternative for Stump Appendicitis Management

Sudan,

Julka,

Patel

2024

ACG Case Rep J

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“…However, appendectomy is not appropriate for some cases of complicated appendicitis, in which extended resection is necessary, particularly in patients with delayed diagnoses, in patients with diffuse peritonitis findings, or elderly patients with severe comorbidities. [ 22 ] In one study, among patients with complicated appendicitis for which simple appendectomy was sufficient, rates of paralytic ileus and wound infection and the overall complication rate were lower, and hospitalization was shorter than among patients who underwent extended resection. [ 22 ] However, simple appendectomy may not be possible in cases of abdominal abscess, cecum perforation, inability to close the appendix stump safely, cecal ischemia, or inflamed mass.…”

Section: Discussionmentioning

confidence: 99%

“…[ 22 ] In one study, among patients with complicated appendicitis for which simple appendectomy was sufficient, rates of paralytic ileus and wound infection and the overall complication rate were lower, and hospitalization was shorter than among patients who underwent extended resection. [ 22 ] However, simple appendectomy may not be possible in cases of abdominal abscess, cecum perforation, inability to close the appendix stump safely, cecal ischemia, or inflamed mass. Higher morbidity rates have been reported among patients with these conditions who require extended resection.…”

Section: Discussionmentioning

confidence: 99%

Comparison of ileocecal resection and right hemicolectomy in the surgical treatment of complicated appendicitis

Turgut

Subaşı

2023

Ulus Travma Acil Cerrahi Derg

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BACKGROUND:Simple appendectomy with a complicated appendicitis diagnosis could prove difficult, sometimes requiring extended resection. Hence, we aimed to compare two procedures that are preferred for extended resection, ileocecal resection, and right hemicolectomy, in terms of patients' demographic data, preoperative laboratory values (white blood cell [WBC], Neutrophil-tolymphocyte ratio [N/L], C-reactive protein [CRP]), operation times, postoperative complications, length of hospital stay, and 1-month mortality rates. METHODS:We retrospectively reviewed patients who underwent extended resection with the diagnosis of complicated appendicitis in our clinic from February 2015 to December 2020. We divided the patients into two groups those who underwent right hemicolectomy and those who underwent ileocecal resection.RESULTS: Among the 55 patients who underwent extended resection with the diagnosis of complicated appendicitis, 32 (58.1%) underwent right hemicolectomy and 23 underwent ileocecal resection (41.8%). The groups did not differ statistically significantly in terms of demographic characteristics, preoperative laboratory values (WBC, N/L, CRP), Clavien-Dindo classification scores, mean hospital stay, or 1-month mortality rates (p>0.005). However, there was a statistically significant difference between the groups in terms of operation time (p<0.001). CONCLUSION:Ileocecal resection is a safe procedure for patients diagnosed with complicated appendicitis who are scheduled for extended resection.

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“…In certain situations, extensive resection may be required for patients with appendicular phlegmon as appendectomy could not be performed due to extensive inflammation. Risk factors for extensive resection include a late presentation, elevated leukocyte, and C-reactive protein [32,33]. Extensive resection for appendicular phlegmon is often seen in twenty five percent of the surgical management of appendicular phlegmon especially when they are encountered intraoperatively [34].…”

Section: Extensive Resection For Appendicular Phlegmonmentioning

confidence: 99%

Appendicular Phlegmon: Current Management

Hari Rajah

2024

ejmhr

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The management of appendicular phlegmon has undergone a paradigm shift in its management from conservative treatment towards immediate appendectomy, with the introduction of laparoscopic appendectomy. The need for an interval appendectomy has also been reduced with this change but the role of extended resection is still debated with there being no consensus of whether to perform a right hemicolectomy or ileocecal resection. We have conducted this review article to investigate the management of appendicular phlegmon especially the role of laparoscopic appendectomy and extended resection.

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Preoperative predictors of extended resection in patients with complicated acute appendicitis undergoing surgery

Cited by 6 publications

References 24 publications

SpyGlass/Cholangioscope-Assisted Colonoscopic Removal of Appendicolith as a Nonsurgical Alternative for Stump Appendicitis Management

SpyGlass/Cholangioscope-Assisted Colonoscopic Removal of Appendicolith as a Nonsurgical Alternative for Stump Appendicitis Management

Comparison of ileocecal resection and right hemicolectomy in the surgical treatment of complicated appendicitis

Appendicular Phlegmon: Current Management

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