Time to appendectomy for acute appendicitis: A systematic review

Cameron, Danielle B.; Williams, Regan F.; Geng, Yimin; Gosain, Ankush; Arnold, Meghan A.; Guner, Yigit S.; Blakely, Martin L.; Downard, Cynthia D.; Goldin, Adam B.; Grabowski, Julia; Lal, Dave R.; Dasgupta, Roshni; Baird, Robert; Gates, Robert L.; Shelton, Julia; Jancelewicz, Timothy; Rangel, Shawn J.; Austin, Mary T.

doi:10.1016/j.jpedsurg.2017.11.042

Cited by 46 publications

(30 citation statements)

References 38 publications

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“…Recently, the American Pediatric Surgical Association Outcomes and Evidence-Based Practice Committee developed recommendations regarding time to appendectomy for AA in children by a systematic review of the published articles between January 1, 1970, and November 3, 2016. The committee stated that appendectomy performed within the first 24 h from presentation is not associated with an increased risk of perforation or adverse outcomes [135].…”

Section: Q23: What Is the Best Non-operative Management Of Patientsmentioning

confidence: 99%

Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines

et al. 2020

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Background and aims: Acute appendicitis (AA) is among the most common causes of acute abdominal pain. Diagnosis of AA is still challenging and some controversies on its management are still present among different settings and practice patterns worldwide. In July 2015, the World Society of Emergency Surgery (WSES) organized in Jerusalem the first consensus conference on the diagnosis and treatment of AA in adult patients with the intention of producing evidence-based guidelines. An updated consensus conference took place in Nijemegen in June 2019 and the guidelines have now been updated in order to provide evidence-based statements and recommendations in keeping with varying clinical practice: use of clinical scores and imaging in diagnosing AA, indications and timing for surgery, use of nonoperative management and antibiotics, laparoscopy and surgical techniques, intra-operative scoring, and perioperative antibiotic therapy.

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Section: Q23: What Is the Best Non-operative Management Of Patientsmentioning

confidence: 99%

Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines

et al. 2020

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“…For over one hundred years, the appendectomy has been the standard of care for all types of acute appendicitis; however, time has not stood still. The open appendectomy has mostly been replaced by the laparoscopic appendectomy, complicated appendicitis is now routinely treated with a postoperative course of antibiotics [5], and even the dogma that suspected appendicitis should be operated on as quickly as possible to prevent perforation is being replaced by the option to delay surgery in selected cases for up to 24 h [6]. In the search for the optimal treatment for appendicitis, we need information on current post-appendectomy complication rates.…”

Section: Introductionmentioning

confidence: 99%

Outcomes after appendectomy in children with acute appendicitis treated at a tertiary paediatric centre: results from a retrospective cohort study

Knaapen

Amstel

et al. 2020

Langenbecks Arch Surg

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Purpose In general, an appendectomy is presumed to have a limited burden of disease. However, in current literature, reported complication rates vary. This study aims to provide additional insights in the incidence of post-appendectomy complications in children with acute appendicitis. Methods This retrospective cohort study included children (0-17 years old) that underwent appendectomy at our tertiary referral centre for suspected acute appendicitis (January 2011-December 2018). Children referred to our centre, and those that underwent non-operative treatment were excluded. Post-appendectomy complications were recorded from electronic medical charts using predefined definitions and classified as severe (Clavien-Dindo III-IV) or less severe (Clavien-Dindo I-II). Results A total of 131 children were included. Simple and complex appendicitis was diagnosed in 66 (50%) and 60 (46%) children, respectively. A non-inflamed appendix was seen in five (4%) children. One or more complications were identified in 33 (25%) patients. Eight (12%) children with simple appendicitis developed a complication, three of these were severe. In children with complex appendicitis, 23 (38%) children developed a complication, 14 of these were severe. Conclusion This study shows a high rate of complications compared with current literature, both in children with simple and complex appendicitis. This is probably the result of our definition of complications and being a tertiary referral centre receiving more severe appendicitis cases. However, these results still show that appendectomy is not always a routine procedure with only few complications. Substantiating the need to keep optimizing treatment for children with appendicitis.

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“…A good clinical observation and repeated physical exams may prevent surgery but false negative clinical evaluation results in increased perforation rates (10,11). A good evaluation provides proper time for surgery, which results in decrease both in perforation risk and negative appendectomy rate.…”

Section: Introductionmentioning

confidence: 99%

Which one in the diagnosis of acute appendicitis: Physical examination, laboratory or imaging? A retrospective analysis in the light of pathological results

et al. 2018

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Background: Acute appendicitis is the most frequently performed emergent operation. Although the clinical signs, symptoms and physical examination are the mainstay of diagnosis, imaging and biochemical tests also help. We analyzed the reliability of our operation decision and the contribution of biochemical tests and imaging to diagnosis in the light of pathological results. Material and Methods: The files of 361 patients (199male and 162 female) who underwent appendectomy were analyzed retrospectively in terms of age, sex, physical examination, blood tests, imaging and pathological results. Results: The mean age of the patients was found 31±13.5. Pathology revealed normal appendix in 20.1% of the cases. The patients with a leukocytosis or more were found an increased possibility of acute appendicitis. Physical examination was still the mainstay in diagnosis and ultrasound had a low sensitivity. Conclusion: Physical examination is still mainstay in acute appendicitis diagnosis. Leukocytosis of 11x10 3 /ml or more increases the possibility of acute appendicitis.

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Time to appendectomy for acute appendicitis: A systematic review

Cited by 46 publications

References 38 publications

Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines

Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines

Outcomes after appendectomy in children with acute appendicitis treated at a tertiary paediatric centre: results from a retrospective cohort study

Which one in the diagnosis of acute appendicitis: Physical examination, laboratory or imaging? A retrospective analysis in the light of pathological results

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