ArticleAnnals of the Royal College of Surgeons of England2011
Increased use of pre-operative imaging and laparoscopy has no impact on clinical outcomes in patients undergoing appendicectomy.
Article in Annals of the Royal College of Surgeons of England, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Mortality Related to Appendectomy; a Population Based Analysis over Two Decades in Finland.World journal of surgery · 2017Article
- Diagnostic value of procalcitonin for acute complicated appendicitis.Nagoya journal of medical science · 2016Article
- Abdominal CT Does Not Improve Outcome for Children with Suspected Acute Appendicitis.The western journal of emergency medicine · 2015Article
- Treatment options of inflammatory appendiceal masses in adults.World journal of gastroenterology · 2013Review
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6 authors.
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No grant is acknowledged in the PubMed record.
Abstract
introductionThe aim of this study was to review changes in the management of acute appendicitis in a ten-year period at a large university teaching hospital in London.
methodsThis was a retrospective cohort study reviewing the medical records of patients who underwent an appendicectomy over a period of 12 months either in 1999 or 2009. Data collected included use of radiological investigations (ultrasonography, computed tomography [CT]), technique of appendicectomy (open [OA] or laparoscopic [LA]), operative time, histopathology and post-operative complications. Univariate and multivariate analysis was performed to assess the influence of variables on the incidence of negative appendicectomy, appendiceal perforation and post-operative complications.
resultsAll of the patients operated on in 1999 (n=109) had OA. Of the patients operated on in 2009 (n=164), 67 had OA, 91 had LA and 6 had LA converted to OA. None of the patients in 1999 had CT whereas in 2009 26% of patients had CT (sensitivity 94.7%, specificity 75.0%). This increased use of pre-operative imaging had no effect on negative appendicectomy (25.7% vs 12.8%, p=0.445), perforation (30.0% vs 21.3%, p=0.308) or complication rates (9.2% vs 10.4%). The complication rate was also similar regardless of whether patients had OA or LA (11.9% vs 9.9%). Multivariate analysis revealed that age was the only predictor of negative appendicectomy (p=0.029) or perforation (p=0.014).
conclusionsThis study shows that significant increase in the use of pre-operative imaging and laparoscopy in the management of patients with acute appendicitis failed to reduce negative appendicectomy, perforation and complications rates. The patient's age was the only predictor of negative appendicectomy and perforation.
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