Laparoscopic Surgery for Acute Appendicitis in Children With Cancer

Singer, Julia; Stringel, Gustavo; Özkaynak, M. Fevzi; McBride, Whitney; Pandya, Samir; Sandoval, Claudio

doi:10.4293/jsls.2015.00066

Cited by 6 publications

(3 citation statements)

References 25 publications

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“…Moreover, these studies support early surgical intervention in leukemic patients with appendicitis because symptoms are resolved more quickly and hospital stays are shorter [3]. Laparoscopic appendectomy appears to be the preferred procedure, resulting in a small wound, fewer wound infections, less pain, rapid recovery, and lower risk of hemorrhagic complications [4,16].…”

Section: Discussionmentioning

confidence: 81%

Acute Appendicitis in a Child With Acute Leukemia and Chemotherapy-Induced Neutropenia: A Case Report and Literature Review

Ali

Alhindi

Alalwan

2020

Cureus

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Acute appendicitis is a rare but important complication in children with leukemia. It can be difficult to diagnose, and it has a complicated disease course, especially in patients receiving chemotherapy. Awareness of these complications is critical, particularly in cases where surgical intervention is required. We report a child with T-cell acute lymphoblastic leukemia and chemotherapy-induced neutropenia who presented with acute appendicitis. He was successfully treated with broad-spectrum empiric antibiotics and a delayed laparoscopic appendectomy.

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Section: Discussionmentioning

confidence: 81%

Acute Appendicitis in a Child With Acute Leukemia and Chemotherapy-Induced Neutropenia: A Case Report and Literature Review

Ali

Alhindi

Alalwan

2020

Cureus

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“…Although not possible in all cases, our policy was to operate as soon as possible in order to avoid a "locus minoris resistantiae", which may cause www.nature.com/scientificreports/ a recurrent episode of appendicitis and/or typhlitis during the next phase of neutropenia as observed in 2 of our 21 patients. While the management of typhlitis comprises the early use of broad-spectrum antibiotics and bowel rest, appendectomy might be the treatment of choice for "pure" appendicitis 2,3,10,15,16 . Whether laparoscopic appendectomy is the preferred procedure in neutropenic children is discussed controversially.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis and management of acute appendicitis in 21 pediatric hematology and oncology patients at a tertiary care cancer center

Mersi

Benkö

Boztug

et al. 2021

Sci Rep

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Acute appendicitis is a rare gastrointestinal complication of anti-cancer chemotherapy and hematopoietic stem cell transplantation. Among a cohort of 2341 hemato-oncologic patients at a pediatric tertiary care cancer center, we identified 21 patients (0.9%) with 23 episodes of acute appendicitis, based on pathological imaging of the appendix and clinical findings. Median age at diagnosis was 10.21 years. Types of underlying disease included acute leukemias (n = 15), solid tumors (n = 4), and aplastic anemia (n = 2). Clinical symptoms seen in > 1 case were recorded for all 23 episodes as follows: abdominal pain, n = 22; abdominal tenderness, n = 4; fever, n = 7; nausea, n = 2; emesis; n = 2; diarrhea, n = 5; and constipation, n = 2. Median leukocyte count at diagnosis was 0.5 × 109/L, with a median of 0.1 × 109/L for the absolute neutrophil count (ANC). All patients received broad-spectrum antibiotics and 18/23 (78%) patients underwent uneventful appendectomy after a median of 5 days and with a median ANC of 0.7 × 109/L. Median duration until continuation of chemotherapy was 17 days for the 20 cases of appendicitis occurring during the patients’ disease course. Overall, 5/21 (19%) patients died including one related to the appendicitis itself which progressed to a typhlitis and was due to a fungal infection. The other fatalities were transplant- (n = 2) and leukemia-related (n = 2). Acute appendicitis is a rare and usually not life-threatening event in pediatric hemato-oncologic patients, which, if managed by prompt administration of broad-spectrum antibiotics (and antimycotics), can be safely followed by an elective (delayed) appendectomy, even before complete recovery of the neutrophils is achieved.

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“…In general, appendectomy seems to be a better choice of treatment for acute appendicitis. 5,[9][10][11] However, in the neutropaenic phase of HSCT, appendectomy is an extremely tough choice for surgeons and haematologists, 12 and none of the patients in such a condition were transferred to receive appendectomy. In this study, we showed that acute appendicitis that occurred in patients during the neutropaenic phase of HSCT could be resolved with internal methods that use a combination of different kinds of full dose broad-spectrum antibiotics, bowel rest and total parenteral nutrition.…”

mentioning

confidence: 99%

Acute appendicitis in leukaemia patients undergoing haematopoietic stem cell transplantation during the neutropaenic phase: a case series from a single BMT centre in China

Zhang

Zhou

Majaw

et al. 2018

Bone Marrow Transplant

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Appendicitis is a rare but life-threatening complication in patients undergoing haematopoietic stem cell transplantation (HSCT). Infectious complications arising from the gastrointestinal tract are common in immunocompromised patients with haematologic malignances. 1,2 Serious infection often occurs in neutropaenic patients, especially during HSCT. Acute appendicitis is frequently reported in leukaemia patients after chemotherapy but is rarely reported during HSCT. The Alvarado Scoring System (the MANTRELS acronym stands for 'Migration, Anorexia-acetone, Nausea-vomiting, Tenderness in right quadrant, Reboud pain, Elevation of temperature, Leukocytosis, Shif to the left'), which is shortened to ASS-MANTRELS, has been used to diagnose acute appendicitis. 3 However, acute appendicitis occurred in HSCT patients during the neutropaenic phase. The indexes of leukocytosis and shift to the left (LS) of the ASS-MANTRELS were not applicable to these patients. Therefore, a standard criterion applicable for such patients who underwent HSCT was set up. Here we report 10 cases of acute appendicitis, which were selected from 776 sequential HSCTs.

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Laparoscopic Surgery for Acute Appendicitis in Children With Cancer

Cited by 6 publications

References 25 publications

Acute Appendicitis in a Child With Acute Leukemia and Chemotherapy-Induced Neutropenia: A Case Report and Literature Review

Acute Appendicitis in a Child With Acute Leukemia and Chemotherapy-Induced Neutropenia: A Case Report and Literature Review

Diagnosis and management of acute appendicitis in 21 pediatric hematology and oncology patients at a tertiary care cancer center

Acute appendicitis in leukaemia patients undergoing haematopoietic stem cell transplantation during the neutropaenic phase: a case series from a single BMT centre in China

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