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

Pędziwiatr, Michał; Lasek, Anna; Wysocki, Michał; Mavrikis, Judene; Myśliwiec, Piotr; Bobowicz, Maciej; Karcz, Wojciech Konrad; Michalik, Maciej; Makarewicz, Wojciech; Major, Piotr; Rubinkiewicz, Mateusz; Stefura, Tomasz; Kenig, Jakub; Polańska-Płachta, Małgorzata; Appendectomy, Pol-LA Polish Laparoscopic

doi:10.5505/tjtes.2018.80103

Cited by 14 publications

(18 citation statements)

References 48 publications

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“…The database included following patient characteristics: sex, age, and body mass index (BMI). It also followed many operative metrics: type of acute appendicitis (uncomplicated or complicated as determined by the presence of gangrenous appendicitis or perforated appendix with or without abscess) 10 , intraoperative adverse events (IAE), and postoperative outcomes (postoperative morbidity, need for surgical reintervention, LOS, and need for readmission to the original surgical department for whatever reason).…”

Section: Methodsmentioning

confidence: 99%

Risk factors for serious morbidity, prolonged length of stay and hospital readmission after laparoscopic appendectomy - results from Pol-LA (Polish Laparoscopic Appendectomy) multicenter large cohort study

Lasek

Wysocki

et al. 2019

Sci Rep

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<50 3269 (70.79%) First operator, n (%) Specialist 2589 (56.06%) Resident 2029 (43.94%) Median operative time, min (IQR) 55 (40-70) Technique, n (%) Clipping 2841 (61.64%) Suturing/ligature 453 (9.79%) Stapler 313 (6.75%) Endoloop 606 (13.11%) Röder loop 403 (8.71%) Complicated appendicitis, n (%) 1269 (27.48%) Uncomplicated appendicitis, n (%) 3349 (72.52%) Intraoperative adverse events, n (%) 104 (2.25%) Drainage, n (%) 3493 (75.64%) Postoperative morbidity, n (%) 310 (6.71%) Clavien-Dindo classification of surgical complications, n (%) I 146 (3.16%) II 80 (1.73%) III 77 (1.67%) IV 4 (0.09%) V 3 (0.06%) Conversions, n (%) 294 (6.37%) Reinterventions after primary procedure, n (%) 98 (2.12%) LOS 3 (2-4) Readmissions, n (%) 118 (2.56%)

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Section: Methodsmentioning

confidence: 99%

Risk factors for serious morbidity, prolonged length of stay and hospital readmission after laparoscopic appendectomy - results from Pol-LA (Polish Laparoscopic Appendectomy) multicenter large cohort study

Lasek

Wysocki

et al. 2019

Sci Rep

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“…No difference in the appendiceal rate was observed between male and female patients, and related studies have reported inconsistent results for sex. Some studies have indicated that a higher proportion of male patients developed appendiceal rupture [ 53 , 54 ], whereas other studies have demonstrated that a higher proportion of female patients developed complicated appendicitis [ 55 , 56 ]. Consistent with the findings of a previous study [ 57 ], BMI was not found to affect the risk of appendiceal rupture.…”

Section: Discussionmentioning

confidence: 99%

Periappendiceal fat-stranding models for discriminating between complicated and uncomplicated acute appendicitis: a diagnostic and validation study

et al. 2021

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Background Recent studies have reported promising outcomes of non-operative treatment for uncomplicated appendicitis; however, the preoperative prediction of complicated appendicitis is challenging. We developed models by incorporating fat stranding (FS), which is commonly observed in perforated appendicitis. Material and methods We reviewed the data of 402 consecutive patients with confirmed acute appendicitis from our prospective registry. Multivariate logistic regression was performed to select clinical and radiographic factors predicting complicated acute appendicitis in our model 1 (involving backward elimination) and model 2 (involving stepwise selection). We compared c statistics among scoring systems developed by Bröker et al. (in J Surg Res 176(1):79–83. https://doi.org/10.1016/j.jss.2011.09.049, 2012), Imaoka et al. (in World J Emerg Surg 11(1):1–5, 2016), Khan et al. (in Cureus. https://doi.org/1010.7759/cureus.4765, 2019), Kim et al. (in Ann Coloproctol 31(5):192, 2015), Kang et al. (in Medicine 98(23): e15768, 2019), Atema et al. (in Br J Surg 102(8):979–990. https://doi.org/10.1002/bjs.9835, 2015), Avanesov et al. (in Eur Radiol 28(9):3601–3610, 2018), and Kim et al. (in Abdom Radiol 46:1–12, 2020). Finally, we examined our models by performing the integrated discrimination improvement (IDI) test. Results Among enrolled patients, 64 (15.9%) had complicated acute appendicitis. We developed new 10-point scoring models by including the following variables: C-reactive protein, neutrophil to lymphocyte ratio, and computed tomography features of FS, ascites, and appendicolith. A cutoff score of ≥ 6 exhibited a high sensitivity of 82.8% and a specificity of 82.8% for model 1 and 81.3% and 82.3% for model 2, respectively, with c statistics of 0.878 (model 1) and 0.879 (model 2). Compared with the model developed by Bröker et al. which included C-reactive protein and the abdominal pain duration (c statistic: 0.778), the models developed by Atema et al. (c statistic: 0.826, IDI: 5.92%, P = 0.0248), H.Y Kim et al. (c statistics: 0.838, IDI: 13.82%, P = 0.0248), and our two models (IDI: 18.29%, P < 0.0001) demonstrated a significantly higher diagnostic accuracy. Conclusion Our models and the scoring systems developed by Atema et al. and Kim et al. were validated to have a high diagnostic accuracy; moreover, our models included the lowest number of variables.

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“…The relationship between duration of symptoms and the risk of progression to complicated AA has been demonstrated in several studies 2,13 . AA has a 5% increase in the risk of perforation every 12 hours after 36 hours, especially in young patients and those over the age of 50 1,13 .…”

Section: Discussionmentioning

confidence: 93%

“…Among the main causes for seeking urgent care and emergency medical care are acute appendicitis (AA) and gallbladder diseases (GBD) 2 , which can serve as a "thermometer" for the emergency surgical service.…”

Section: Introductionmentioning

confidence: 99%

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The impact of COVID-19 and social avoidance in urgent and emergency surgeries – will a delay in diagnosis result in perioperative complications?

Piltcher-da-Silva

Castro

Trapp

et al. 2021

Rev. Assoc. Med. Bras.

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OBJECTIVE:The sudden COVID-19 outbreak has changed our health system. Physicians had to face the challenge of treating a large number of critically ill patients with a new disease and also maintain the essential healthcare services functioning properly. To prevent disease dissemination, authorities instructed people to stay at home and seek medical care only if they experienced respiratory distress.However, there are concerns those patients did not seek necessary health care because of these orientations. This study aims to see how the pandemic has influenced the severity of the disease, complication, and mortality of patients undergoing emergency cholecystectomy and appendectomy.METHODS: Retrospective review of medical records of patients admitted to the emergency department and undergoing to cholecystectomy and appendicectomy in the periods from March to May 2019 and 2020. RESULTS:We observed that COVID-19 did not change the severity of presentation or the outcome of patients with gallbladder disease, but caused a 24.2% increase in the prevalence of complicated appendicitis (p<0.05). However, disagreeing with what was expected, we did not identify a greater number of perioperative complications in patients undergoing an appendectomy.CONCLUSION: Therefore, it seems that in a university tertiary referral center COVID-19 did not influence the management and outcome of inflammatory diseases treated in the surgical emergency department.

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

Cited by 14 publications

References 48 publications

Risk factors for serious morbidity, prolonged length of stay and hospital readmission after laparoscopic appendectomy - results from Pol-LA (Polish Laparoscopic Appendectomy) multicenter large cohort study

Risk factors for serious morbidity, prolonged length of stay and hospital readmission after laparoscopic appendectomy - results from Pol-LA (Polish Laparoscopic Appendectomy) multicenter large cohort study

Periappendiceal fat-stranding models for discriminating between complicated and uncomplicated acute appendicitis: a diagnostic and validation study

The impact of COVID-19 and social avoidance in urgent and emergency surgeries – will a delay in diagnosis result in perioperative complications?

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