Comparison of laparoscopic and open appendectomy on wound infection and healing in complicated appendicitis

Güler, Yılmaz; Karabulut, Zülfikar; Çalış, Hasan; Şengül, Serkan

doi:10.1111/iwj.13347

Cited by 15 publications

(16 citation statements)

References 24 publications

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“…This is surprising considering that the vast majority of appendicectomies were performed laparoscopically prior to 20th March 2020 in contrast to the open approach after that date. In fact, published literature suggests that open appendicectomy is associated with increased wound infection rates [15]. While we did not observe this in our study, it is possible that patients with a wound infection self-cared or sought help from primary care, and therefore, did not attend secondary care.…”

Section: Discussioncontrasting

confidence: 72%

Changes in the Emergency General Surgery Operations in the Setting of COVID-19 and Impact of Strategy of Non-Operative Management on Outcomes in Acute Appendicitis

Ahmad¹,

Sadien²,

Ivanov³

2022

Cureus

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Background: Coronavirus disease 2019 has posed significant challenges to the provision of elective and emergency general surgical care. Patterns of presentation have changed and management pathways have also been adapted, moving to more non-operative management (NOM) for some conditions. We investigated how COVID-19 changed the volume of emergency general surgery operating in our district general hospital (DGH). We aimed to evaluate the impact of NOM on outcomes in acute appendicitis.Methods: A retrospective case review of operating lists, patient handover lists, and patient notes was undertaken for patients presented between 1 st January 2020 and 3 rd June 2020. The study period was divided into two, with the period between 1 st January 2020 and 23 rd March 2020 representing the pre-COVID cohort.Results: Some 393 emergency general surgery operations were performed in the study period. There was a clear reduction in operating volume after 23 rd March 2020. During that same period, 325 patients were assessed with right iliac fossa (RIF) pain. Median age was 21 (range 5-87) and 201 patients were female (61.8%). The rate of NOM for suspected acute appendicitis was 8.8% in the pre-COVID group, which increased to 36.4% in the COVID group. The incidence of normal histology following appendicectomy did not change with this difference in management (16.1% compared to 17.9%, p = 0.78).Conclusions: This study summarizes the changes brought to the provision of emergency general surgery in the setting of a DGH by the COVID-19 pandemic. In particular, NOM was the preferred option for acute appendicitis but this did not alter the negative appendicectomy rate.

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Section: Discussioncontrasting

confidence: 72%

Changes in the Emergency General Surgery Operations in the Setting of COVID-19 and Impact of Strategy of Non-Operative Management on Outcomes in Acute Appendicitis

Ahmad¹,

Sadien²,

Ivanov³

2022

Cureus

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“…Most patients with acute appendicitis are subjected to appendectomy which requires a relatively short time of recovery. 3 , 4 , 5 Without timely and effective intervention, unexpected serious consequences may arise due to acute complicated appendicitis, which is defined as the presence of either a gangrene, abscess or perforation. 6 …”

Section: Introductionmentioning

confidence: 99%

Complicated appendicitis are common during the epidemic period of 2019 novel coronavirus (2019-nCoV)

Gao¹,

Li²,

Zhou³

et al. 2020

Asian Journal of Surgery

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Objectives To assess the prevalence of complicated appendicitis (including gangrene, abscess and perforation) after the outbreak of the 2019-nCoV epidemic and to identify the risk factors associated with complicated appendicitis. Methods Two groups were established in the study consisting of: one group for cases of acute appendicitis before the 2019-nCoV epidemic (before January 1, 2020; pre-epidemic group) and another group for those after the epidemic outbreak (after January 1, 2020; epidemic group). These two groups were compared in terms of demographic and clinical characteristics, prevalence of complicated appendicitis, and treatment intention. A multivariate analysis model using binary logistic regression was constructed. Results A total of 163 patients were included in this study, with 105 in the pre-epidemic group and 58 in the epidemic group. In the epidemic group, the interval from the onset of symptoms to admission was 65.0 h, which is significantly longer than the 17.3 h interval noted in the pre-epidemic group ( P < 0.001). The prevalence of complicated appendicitis after the epidemic outbreak was significantly higher than before the outbreak (51.7% vs. 12.4%, P < 0.001). In addition, the epidemic group had a lower score of patient’s intention to seek treatment than the pre-epidemic group (9.5 ± 2.7 vs. 3.4 ± 2.6, P < 0.001). Based on the multivariate analysis, the risk factors for complicated appendicitis included the time from symptoms onset to admission (OR = 1.075) and the patients’ intention to receive treatment (OR = 0.541). Conclusion Complicated appendicitis was more common in patients with acute appendicitis after the outbreak of the 2019-nCoV epidemic.

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“…Many studies pointed out that compared to an open appendectomy, laparoscopic surgery leads to a desirable outcome, lower rate of complications, shorter postoperative recovery time, less postoperative pain, and scarring. There was no effect on the operation time [ 25 , 26 ]. In our study, only one patient had to be converted to open surgery during LA.…”

Section: Discussionmentioning

confidence: 99%

Decision-making changes for patients and medical personnel in the management of acute appendicitis during the COVID-19 pandemic

Cai

Zheng

et al. 2022

BMC Emerg Med

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Background Acute appendicitis is the most common cause of acute abdomen. During the pandemic, to contain the spread of COVID-19, there were some integral changes in the medical processes based on the pandemic prevention policy, especially regarding emergency surgery. This study was conducted to investigate whether this pandemic also impacted the decision-making for both patients and medical personnel along with the treatment outcomes. Methods Patients of age 18 years or older who were diagnosed clinically and radiologically with acute appendicitis between Jan 1, 2017, and Dec 31, 202,0 were reviewed. The data of 1991 cases were collected and used for this study. Two groups were formed, one group before and the other group after the outbreak. The gathered data included gender, age, appendiceal fecalith, outcomes of treatment, and long-term outcomes of non-operation (8 months follow-up). We also collected details of surgical cases from the above two groups. This data also included age, gender, appendiceal fecalith, fever, jaundice, length of onset before presenting to an emergency department (ED), anesthesia, surgery, white cell count, pathology, complications, and length of stay. We compared the above data respectively and analyzed the differences. Results Compared to the period before the outbreak, patient visits for acute appendicitis remarkably dropped (19.8%), but surgical cases showed no change (dropped by roughly 5%). There were significant differences (P < 0.05) in failure of non-operation(after the pandemic 8.31% vs. before pandemic 3.22%), interval appendectomy(after pandemic 6.29% vs. before pandemic 12.84%), recurrence(after pandemic 23.27% vs. before pandemic 14.46%), and outcomes of recurrence. There was a significant difference (P < 0.05) in anesthesia method, surgery way, and complications( before pandemic 4.15% vs. after pandemic9.89% P < 0.05) in patients who underwent the surgery. There was no statistical difference (P > 0.05) concerning age, gender, fever, jaundice, appendiceal fecalith, white cell count, and length of onset before presenting to the ED. Conclusion The current pandemic prevention policy is very effective, but some decision-making processes of doctor-patient have changed in the context of COVID-19 pandemic, that further influenced some treatment outcomes and might lead to a potential economic burden. It is essential to address the undue concern of everyone and optimize the treatment process.

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Comparison of laparoscopic and open appendectomy on wound infection and healing in complicated appendicitis

Cited by 15 publications

References 24 publications

Changes in the Emergency General Surgery Operations in the Setting of COVID-19 and Impact of Strategy of Non-Operative Management on Outcomes in Acute Appendicitis

Changes in the Emergency General Surgery Operations in the Setting of COVID-19 and Impact of Strategy of Non-Operative Management on Outcomes in Acute Appendicitis

Complicated appendicitis are common during the epidemic period of 2019 novel coronavirus (2019-nCoV)

Decision-making changes for patients and medical personnel in the management of acute appendicitis during the COVID-19 pandemic

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