Current status of laparoscopy for acute abdomen in Italy: a critical appraisal of 2012 clinical guidelines from two consecutive nationwide surveys with analysis of 271,323 cases over 5 years

Agresta, Ferdinando; Campanile, Fabio Cesare; Podda, Mauro; Cillara, Nicola; Pernazza, Graziano; Giaccaglia, Valentina; Ciccoritti, Luigi; Ioia, G.; Mandalà, Stefano; Barbera, C.; Birindelli, Arianna; Sartelli, Massimo; Saverio, Salomone Di

doi:10.1007/s00464-016-5175-4

Cited by 37 publications

(14 citation statements)

References 38 publications

(31 reference statements)

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“…[10,11] Moreover, LA has been shown to be safer in complicated AA than in open surgery; therefore, its use in the emergency setting is rising. [12][13][14][15][16] While challenging, discrimination between uncomplicated and complicated AA is clinically relevant as outcomes vary, with complicated cases faring worse. [17] Additionally, patients with uncomplicated AA may be successfully treated with antibiotics, in comparison to complicated cases, which practically always require an appendectomy.…”

Section: Introductionmentioning

confidence: 99%

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

Pędziwiatr

Lasek

Wysocki

et al. 2018

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: Preoperative classification of complicated and uncomplicated appendicitis (AA) is challenging. However, the differences in surgical outcomes necessitate the establishment of risk factors in developing, complicated AA. This study was an analysis of the clinical outcomes of laparoscopic appendectomies (LA), as well as preoperative risk factors for the development of complicated AA. METHODS: The data of 618 patients who underwent LA in 18 surgical units across Poland and Germany were collected in an online web-based database created by the Polish Videosurgery Society. The surgical outcomes of patients with complicated and uncomplicated appendicitis were compared. Uni-and multivariate logistic regression models were used to establish risk factors for the development of complicated appendicitis. RESULTS: In all, 1269 (27.5%) patients underwent LA for complicated appendicitis (Group 1) and 3349 (72.5%) for uncomplicated appendicitis (Group 2). The conversion rate, number of intra-operative adverse events, re-intervention rate, postoperative complications, and readmission rate was greater in Group 1. The preoperative risk factors associated with complicated appendicitis were:

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Section: Introductionmentioning

confidence: 99%

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

Pędziwiatr

Lasek

Wysocki

et al. 2018

Ulus Travma Acil Cerrahi Derg

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“…Based on our clinical observations, we can say that we have come a long way in the selection and performance of laparoscopy. In their well-attended survey on surgeons in Italy, Agresta et al [11] reported that laparoscopy is increasingly being used in acute abdominal surgeries performed in the period of 2010-2014.…”

Section: Discussionmentioning

confidence: 99%

Role of Laparoscopy Procedure in the Diagnosis and Treatment of Traumatic Acute Abdomen

Kanlıöz¹

2019

Laparosc Endosc Surg Sci

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Introduction: The objective of this study was to analyze the role of laparoscopy in the diagnosis and treatment of traumatic acute abdomen. Materials and Methods: Cases of patients with traumatic acute abdomen from between 2009 and 2017 diagnosed with laparoscopy but not examination, laboratory tests, or radiological methods were reviewed. These were patients with unstable vital signs for whom time was critical. The patient demographic data, causes of acute abdomen, procedures applied, and duration of hospitalization were analyzed. Results: Of the total of 138 patients, the cause of admission was a traffic accident in 46 cases (33.33%), sharp object injury in 27 (19.56%), gunshot injury in 19 (13.76%), falling from a height in 16 (11.59%), work accident in 14 (10.14%), physical violence in 9 (6.92%), sports injury in 4 (2.89%), and an animal kick in 3 (2.17%). In all, 56 (40.58%) were female and 82 (59.42%) were male. The mean age was 27.45±9.81 years. Of the patients, 64 (46.38%) had only abdominal trauma, while 74 (53.62%) had multiple trauma. The procedures performed included 83 (60.14%) diagnostic laparoscopies, 30 (21.74%) laparoscopies with additional laparoscopic procedures, and 25 (18.11%) instances of post-laparoscopy open surgery. In the group, 113 (81.88%) were discharged after healing; morbidity and mortality were observed in 21 (15.22%) and 4 (2.89%), respectively. The mean hospital stay was 2.82±1.64 days in patients with only abdominal trauma and 4.34±2.08 days in those with multiple trauma. Conclusion: Laparoscopy contributes significantly to the diagnosis and treatment of selected patients.

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“…Se ha demostrado su seguridad y beneficios también en pacientes con cuadros agudos abdominales. De hecho, el abordaje laparoscópico en la emergencia es capaz de proporcionar una mejor visión de toda la cavidad abdominal con un trauma mínimo dando la posibilidad de realizar un diagnóstico preciso y al mismo tiempo un tratamiento definitivo (10) . Las ventajas de la cirugía miniinvasiva son particularmente atractivas en la emergencia y su uso ha ido en aumento en los últimos diez años (10,11) .…”

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Análisis de la laparoscopía diagnóstica y estudios de imagen en el manejo del dolor en fosa ilíaca derecha de etiología incierta

Sosa¹,

Paredes

Larrosa³

et al. 2019

RMU

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Introducción: el dolor en la fosa ilíaca derecha (FID) es un motivo de consulta habitual en los servicios de urgencias. El principal desafío es diferenciar si es un cuadro quirúrgico o no. Objetivo: conocer qué rol ocupa la laparoscopía diagnóstica (LD), la ecografía de abdomen y la tomografía computada (TC) en el algoritmo de estudio de los pacientes con dolor en FID con diagnóstico incierto en Uruguay. Método: estudio observacional, descriptivo, prospectivo, multicéntrico, sobre pacientes que consultaron por dolor en FID desde el 1º de junio al 31 de agosto de 2017 en centros asistenciales de Uruguay. Se recolectaron los siguientes datos en una planilla electrónica: sexo, edad, sintomatología, hallazgos físicos, exámenes solicitados, conducta tomada, hallazgos intraoperatorios, complicaciones. Resultados: se completaron 159 planillas. Luego de una valoración primaria se planteó duda diagnóstica en 69 (43,4%) pacientes. La TC se solicitó en 29 (42%) pacientes. Se realizó TC al 78% de los mayores de 50 años versus 18% entre los de 15 y 29 años. Del total, 13 (44,8%) se informaron como normales, confirmando en el intraoperatorio cuatro (30,7%) apendicitis agudas. Se realizaron 29 LD en los casos con duda diagnóstica, dos tercios fueron en pacientes de 15 a 29 años. En 22 (76%) casos se arribó a un diagnóstico. No hubo complicaciones. Conclusiones: la LD permitió realizar diagnóstico y tratamiento en la mayoría de los casos. La sensibilidad de la TC fue baja en comparación con datos internacionales. El algoritmo diagnóstico debe ser individualizado, basado en protocolos adaptados a los recursos de cada institución. Palabras clave: Dolor en fosa ilíaca derecha Apendicitis aguda Laparoscopía Diagnóstico por imagen

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Current status of laparoscopy for acute abdomen in Italy: a critical appraisal of 2012 clinical guidelines from two consecutive nationwide surveys with analysis of 271,323 cases over 5 years

Abstract: The surveys showed an increasing use of laparoscopy for patients with abdominal emergencies. The 2012 national guidelines profoundly influenced the Italian surgical practice in the laparoscopic approach to the acute abdomen.

Cited by 37 publications

References 38 publications

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

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

Role of Laparoscopy Procedure in the Diagnosis and Treatment of Traumatic Acute Abdomen

Análisis de la laparoscopía diagnóstica y estudios de imagen en el manejo del dolor en fosa ilíaca derecha de etiología incierta

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