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Benign bowel disease
Colorectal screening following appendectomy in adult patients: a systematic review
Francesco Esposito, Marco Del Prete, Matilde Magri, Fanny Dufour, Alexandre Cortes
Ann Coloproctol. 2024;40(5):417-423.   Published online August 1, 2024
DOI: https://doi.org/10.3393/ac.2023.00528.0075
  • 980 View
  • 57 Download
AbstractAbstract PDF
Purpose
Although the association between appendicitis and colorectal cancer in older patients has received attention, postoperative colorectal screening through endoscopy is not currently recommended. This study conducted a systematic review of the literature on colorectal screening following appendectomy in adult patients.
Methods
A literature search was performed using online databases. Studies reporting colorectal surveillance after appendectomy in adult patients were retrieved for assessment.
Results
Eight articles including a total of 3,995 patients were published between 2013 and 2023. An age of 40 years was the lower threshold in 6 of the 8 articles. Postoperative colorectal screening occurred in 771 patients (19.3%). Endoscopy was performed in 95.2% of cases and computed tomography–colonography in 4.8%. During endoscopic examinations, a lesion was discovered in 184 of 771 patients (24.0%), and an adenomatous polyp was found in 154 of 686 patients (22.5%). The overall cancer rate was 3.9% (30 of 771 patients). The tumor was located in the right-sided colon in 46.7% of the patients, in the cecum in 20.0%, in the rectum in 16.7%, in the left-sided colon in 10.0%, and in the sigmoid colon in 6.7%.
Conclusion
Performing post-appendectomy colorectal screening in patients >40 years of age could allow early detection of an underlying lesion.
Original Articles
Benign bowel disease
Implications of bacteriological study in complicated and uncomplicated acute appendicitis
Sorin Cimpean, Alberto Gonzalez Barranquero, Ion Surdeanu, Benjamin Cadiere, Guy-Bernard Cadiere
Received February 28, 2022  Accepted July 7, 2022  Published online November 10, 2022  
DOI: https://doi.org/10.3393/ac.2022.00157.0022    [Epub ahead of print]
  • 2,346 View
  • 87 Download
  • 2 Citations
AbstractAbstract PDF
Purpose
Bacteriological sample in the presence of intra-abdominal free fluid is necessary to adapt the antibiotherapy and to prevent the development of resistance. The aim was to evaluate the differences between uncomplicated acute appendicitis (UAA) and complicated acute appendicitis (CAA) in terms of bacterial culture results and antibiotic resistance, and to evaluate the factors linked with CAA.
Methods
We performed a single-center, retrospective observational study of all consecutive patients who presented with appendicular peritonitis and underwent emergent surgery in a tertiary referral hospital in Brussels, Belgium, between January 2013 and December 2020. The medical history, parameters at admission, bacterial culture, antibiotic resistance, and postoperative outcomes of 268 patients were analyzed. UAA was considered catarrhal or phlegmonous inflammation of the appendix. CAA was considered gangrenous or perforated appendicitis.
Results
Positive microbiological cultures were significantly higher in the CAA group (68.2% vs. 53.4%). The most frequently isolated bacteria in UAA and CAA cultures were Escherichia coli (37.9% and 48.6%, respectively). Most observed resistances were against ampicillin (28.9% and 21.7%) and amoxicillin/clavulanic acid (16.4% and 10.5%) in UAA and CAA, respectively. A higher Charlson Comorbidity Index, an elevated white blood cell count, an open procedure, and the need for drainage were linked to CAA. Culture results, group of bacterial isolation, and most common isolated bacteria were not related to CAA.
Conclusion
CAA presented a higher rate of positive cultures with increased identification of gram-negative bacteria. Bacterial culture from the peritoneal liquid does not reveal relevant differences in terms of antibiotic resistance.

Citations

Citations to this article as recorded by  
  • Causative microbes and antibiotic susceptibility of acute appendicitis in adults and children
    Chia-Hsiang Yu, Chia-Ning Chang, Chih-Chien Wang
    Pediatrics & Neonatology.2024; 65(2): 159.     CrossRef
  • The role of intraoperative swab during appendectomy in patients with uncomplicated and complicated appendicitis
    Bruno Leonardo Bancke Laverde, Matthias Maak, Melanie Langheinrich, Stephan Kersting, Axel Denz, Christian Krautz, Georg F. Weber, Robert Grützmann, Maximilian Brunner
    International Journal of Colorectal Disease.2023;[Epub]     CrossRef
Benign GI diease,Benign diesease & IBD,Surgical technique
Clinical outcomes of locking polymeric clip for laparoscopic appendectomy in patients with appendicitis: a retrospective comparison with loop ligature
Seokwon Kim, Byong Ho Jeon, Sang Sik Cho, Ui Sup Shin, Sun Mi Moon
Ann Coloproctol. 2022;38(2):160-165.   Published online January 18, 2022
DOI: https://doi.org/10.3393/ac.2021.00598.0085
  • 2,922 View
  • 178 Download
  • 3 Web of Science
  • 2 Citations
AbstractAbstract PDF
Purpose
This study aimed to compare the clinical outcomes of laparoscopic appendectomy (LA) according to the method of appendiceal stump closure.
Methods
Patients who underwent LA for appendicitis between 2010 and 2020 were retrospectively reviewed. Patients were classified into locking polymeric clip (LPC) and loop ligature (LL) groups. Clinical outcomes were compared between the groups.
Results
LPC and LL were used in 188 (56.6%) and 144 patients (43.4%), respectively for appendiceal stump closure. No significant differences were observed in sex, age, comorbidities, and the severity of appendicitis between the groups. The median operative time was shorter in the LPC group than in the LL group (64.5 minutes vs. 71.5 minutes, P=0.027). The median hospital stay was longer in the LL group than in the LPC group (4 days vs. 3 days, P=0.020). Postoperative incidences of intraabdominal abscess and ileus were higher in the LL group than in the LPC group (4.2% vs. 1.1%, P=0.082 and 2.8% vs. 0%, P=0.035; respectively). The readmission rate was higher in the LL group than that in the LPC group (6.3% vs. 1.1%, P=0.012).
Conclusion
Using LPC for appendiceal stump closure during LA for appendicitis was associated with lower postoperative complication rate, shorter operative time, and shorter hospital stay compared to the use of LL. Operative time above 60 minutes and the use of LL were identified as independent risk factors for postoperative complications in LA. Therefore, LPC could be considered a more favorable closure method than LL during LA for appendicitis.

Citations

Citations to this article as recorded by  
  • Comparison of polymeric clip and endoloop in laparoscopic appendectomy: A systematic review and meta-analysis
    Aashish Kumar, Muhammad Saqlain Mustafa, Muhammad Ashir Shafique, Abdul Haseeb, Hussain Sohail Rangwala, Haimath Kumar, Burhanuddin Sohail Rangwala, Adarsh Raja, Sandesh Raja, Syed Muhammad Sinaan Ali
    Surgery.2024; 176(5): 1329.     CrossRef
  • Advantages of using a polymeric clip versus an endoloop during laparoscopic appendectomy in uncomplicated appendicitis: a randomized controlled study
    Kil-yong Lee, Jaeim Lee, Youn Young Park, Seong Taek Oh
    World Journal of Emergency Surgery.2023;[Epub]     CrossRef
Case Report
Benign bowel disease
Perioperative considerations for acute appendicitis in patients with COVID-19 infection: two case reports
In-Kyeong Kim, Seung-jin Kwag, Han-Gil Kim, Young-Tae Ju, Seung-Jun Lee, Tae-Jin Park, Sang-Ho Jeong, Eun-Jung Jung, Jin-Kwon Lee
Ann Coloproctol. 2023;39(6):521-525.   Published online December 7, 2021
DOI: https://doi.org/10.3393/ac.2021.00647.0092
  • 3,738 View
  • 136 Download
AbstractAbstract PDF
We report considerations related with surgery through 2 cases of acute apendicitis with COVID-19 infection. In November and December 2020, two patients infected with COVID-19 developed acute apendicitis and underwent emergency surgery. In case 1, an 84-year-old woman was asymptomatic and diagnosed with acute apendicitis on the 20th day of infection. She was discharged after surgery without complication. In contrast, case 2 was a 69-year-old male patient with pneumonia treated with antibiotics, steroids and remdesivir. After surgery, he was hospitalized for a long duration due to persistent pneumonia and wound complications. We should perform appendectomy in well-established negative pressure operating rooms, personal protective equipment, and protocols. Since the physical examination and blood tests were limited, image examination like computed tomography scan should be considered if acute apendicitis is suspected. If the patient has pneumonia before surgery, it can get worse after surgery, and complications such as wound infections can occur.
Original Article
Risk factors for prolonged hospitalization and delayed treatment completion after laparoscopic appendectomy in patients with uncomplicated acute appendicitis
Jiyoung Shin, Myong Hoon Ihn, Kyung Sik Kim, Sang Hyun Kim, Jihyoun Lee, Sangchul Yun, Sung Woo Cho
Ann Coloproctol. 2023;39(1):50-58.   Published online November 18, 2021
DOI: https://doi.org/10.3393/ac.2021.00773.0110
  • 3,540 View
  • 149 Download
  • 1 Citations
AbstractAbstract PDFSupplementary Material
Purpose
We sought to identify the risk factors for prolonged hospitalization and delayed treatment completion after laparoscopic appendectomy in patients with uncomplicated acute appendicitis.
Methods
The study retrospectively analyzed 497 patients who underwent laparoscopic appendectomies for uncomplicated appendicitis between January 2018 and December 2020. The patients were divided into an early discharge group (≤2 days) and a late discharge group (>2 days) based on the length of hospital stay (LOS). The patients were also divided into uneventful and complicated groups according to the need for additional treatment after standard follow-up.
Results
Thirty-seven patients (7.4%) were included in the late discharge group. The mean LOS of the late discharge groups was 3.9 days. There were significant differences according to age, preoperative C-reactive protein (CRP), and operative time between the 2 groups. Only operative time was significantly associated with prolonged LOS in multivariate analysis. Thirty-five patients (7.0%) were included in the complicated group. The mean duration of treatment in the uneventful and complicated groups was 7.4 and 25.3 days, respectively. Significant differences existed between the uneventful and complicated groups in preoperative body temperature, preoperative CRP levels, maximal appendix diameter, and the presence of appendicoliths. In multivariate analysis, preoperative CRP levels and maximal appendix diameter were independent predictors of delayed treatment completion.
Conclusion
Shorter operative time is desirable to ensure minimal hospital stay in patients with uncomplicated appendicitis. Further efforts are needed to ensure that patients with uncomplicated appendicitis do not experience delayed treatment completion after laparoscopic appendectomies.

Citations

Citations to this article as recorded by  
  • Comparative Outcomes of Immediate and Delayed Wound Closure Techniques in Appendectomies for Gangrenous Appendicitis
    Anzar Usman, Esha Akbar, Aliha Mukhtar, Iqra Nasir, Usama Rehman, Adil Iqbal, Muhammad Rashid, Muhammad Umar
    DEVELOPMENTAL MEDICO-LIFE-SCIENCES.2024; 1(3): 35.     CrossRef
Case Reports
A rare presentation of low-grade appendiceal mucinous neoplasm within an amyand’s hernia: a case report
Hani Atiqah Saim, Ian Chik, Fahrol Fahmy Jaafar, Zamri Zuhdi, Razman Jarmin, Azlanudin Azman
Ann Coloproctol. 2023;39(2):183-187.   Published online October 18, 2021
DOI: https://doi.org/10.3393/ac.2021.00430.0061
  • 7,477 View
  • 122 Download
  • 3 Web of Science
  • 1 Citations
AbstractAbstract PDF
An Amyand’s hernia is characterised as the presence of the appendix in an inguinal hernial sac. During laparoscopic cholecystectomy for gallbladder polyps, an incidental Amyand’s hernia was discovered in a 75-year-old female patient. On examination, the hernia contained an appendiceal mucocele but no evidence of perforation. An open appendicectomy with tension-free mesh repair was performed for the hernia. The histopathological report of the appendix was a low-grade appendiceal mucinous neoplasm (LAMN), an entity that is just as rare as an Amyand’s hernia. The patient had the right inguinal swelling for over 10 years but it was thought to be an inguinal intramuscular cyst as reported on a previous abdominal ultrasound. Mucocele of the appendix may have a benign or malignant appendiceal progress, leading to individualised diagnosis and treatment. We review an Amyand’s hernia with LAMN and discuss the asymptomatic tendency yet malignant potential of appendiceal mucoceles along with treatment strategies.

Citations

Citations to this article as recorded by  
  • Complicated Appendicitis Associated With Appendiceal Mucinous Neoplasm Within Amyand’s Hernia in a Patient With Previous Hernia Repair: A Case Report and Literature Review
    Carlos A Navarro-Castañeda, Luis A Pérez-Silva, Rubén A Sandoval-Barba, Nubia A Ramírez-Buensuceso-Conde, Jorge Farell-Rivas
    Cureus.2024;[Epub]     CrossRef
Benign bowel disease
A fecalith mimicking a bladder calculus secondary to an appendicovesical fistula: a case report
Mauricio Gonzalez-Urquijo, Andrea Romero-Davila, MaryCarmen Mendoza-Silva, Antonio Nassim Halun Treviño, Mario Rodarte-Shade, Gerardo Gil-Galindo
Ann Coloproctol. 2023;39(4):362-365.   Published online July 21, 2021
DOI: https://doi.org/10.3393/ac.2020.00311.0044
  • 4,430 View
  • 40 Download
AbstractAbstract PDF
An appendicovesical fistula is defined as an abnormal communication between the appendix and the urinary bladder, with only a few cases reported in the literature. It is very challenging to make an early diagnosis, due to the inability of conventional imaging modalities to detect this unique pathology. The symptoms are often mild, and there are not any specific signs or symptoms that might suggest this type of anomalous communication. We report a case of a 27-year-old male patient who presented difficulty for initiating urination, dysuria, and persistent urinary tract infections. An abdominal x-ray showed a large calculus inside the bladder. A cystoscopy was performed, where the tip of the appendix was seen protruding inside the bladder with a large fecalith adhered to the bladder wall. An appendectomy and partial cystectomy with primary repair were auspiciously achieved. A review of the literature is also presented.
Benign GI diease,Rare disease & stoma
De Garengeot’s Hernia Treated With a Hybrid Approach: A Case Report
Mohamed Alkashty, Ben Dickinson, Giovanni D. Tebala
Ann Coloproctol. 2021;37(Suppl 1):S55-S57.   Published online May 28, 2021
DOI: https://doi.org/10.3393/ac.2020.09.21.2
  • 2,777 View
  • 47 Download
  • 1 Web of Science
  • 2 Citations
AbstractAbstract PDF
De Garengeot’s hernia happens when an inflamed or ischemic appendix is located within an incarcerated femoral hernia. We hereby report a case of De Garengeot’s hernia treated with a combined open and laparoscopic approach. An 80-year-old male presented to the emergency department with a 1-day history of a tender right inguinal mass. A computed tomography scan revealed a direct right inguinal hernia containing an incarcerated appendix. At surgery, the diagnosis of a strangulated appendix within a femoral hernia was made. To avoid a wide disruption of the right groin region, the ischemic appendix was reduced into the abdomen and removed laparoscopically. The femoral defect was treated by open plug repair. De Garengeot’s hernia may represent a surgical challenge. A combined open and laparoscopic approach is a good option in these cases.

Citations

Citations to this article as recorded by  
  • The Utility of Minimally Invasive Surgery in the Emergency Management of Femoral Hernias: A Systematic Review
    Paul Shuttleworth, Shariq Sabri, Andrei Mihailescu
    Journal of Abdominal Wall Surgery.2023;[Epub]     CrossRef
  • Transverse colon and omental incarceration in femoral hernia: a case report
    Badhaasaa Beyene Bayissa, Ayantu Mekonnon Borena
    Journal of Surgical Case Reports.2023;[Epub]     CrossRef
Original Articles
Benign GI diease
Routine Intraoperative Bacterial Culture May Be Needed in Complicated Appendicitis
Jung Tack Son, Gue Chun Lee, Hyung Ook Kim, Taewoon Kim, Donghyoun Lee, Sung Ryol Lee, Kyung Uk Jung, Hungdai Kim, Ho-Kyung Chun
Ann Coloproctol. 2020;36(3):155-162.   Published online June 30, 2020
DOI: https://doi.org/10.3393/ac.2019.11.04.1
  • 4,173 View
  • 124 Download
  • 9 Web of Science
  • 11 Citations
AbstractAbstract PDF
Purpose
Choosing the appropriate antibiotic is important for treatment of complicated appendicitis. However, increasing multidrug resistant bacteria have been a serious problem for successful treatment. This study was designed to identify bacteria isolated from patients with complicated appendicitis and reveal their susceptibilities for antibiotics and their relationship with patient clinical course.
Methods
This study included patients diagnosed with complicated appendicitis and examined the bacterial cultures and antimicrobial susceptibilities of the isolates. Data were retrospectively collected from medical records of Kangbuk Samsung Hospital from January 2008 to February 2018.
Results
The common bacterial species cultured in complicated appendicitis were as follows: Escherichia coli (n=113, 48.9%), Streptococcus spp. (n=29, 12.6%), Pseudomonas spp. (n=23, 10.0%), Bacteriodes spp. (n=22, 9.5%), Klebsiella (n=11, 4.8%), and Enterococcus spp. (n=8, 3.5%). In antibiotics susceptibility testing, the positive rate of extended-spectrum beta lactamase (ESBL) was 9.1% (21 of 231). The resistance rate to carbapenem was 1.7% (4 of 231), while that to vancomycin was 0.4% (1 of 231). E. coli was 16.8% ESBL positive (19 of 113) and had 22.1% and 19.5% resistance rates to cefotaxime and ceftazidime, respectively. Inappropriate empirical antibiotic treatment (IEAT) occurred in 55 cases (31.8%) and was significantly related with organ/space surgical site infection (SSI) (7 of 55, P=0.005).
Conclusion
The rate of antibiotic resistance organisms was high in community-acquired complicated appendicitis in Koreans. Additionally, IEAT in complicated appendicitis may lead to increased rates of SSI. Routine intraoperative culture in patients with complicated appendicitis may be an effective strategy for appropriate antibiotic regimen.

Citations

Citations to this article as recorded by  
  • Culture-based bacterial evaluation of the appendix lumen and antibiotic susceptibility of acute appendicitis in Japan: A single-center retrospective analysis
    Hiroe Kitahara, Yonfan Park, Kai Seharada, Masaki Yoshimura, Akira Horiuchi, Yukihiko Karasawa
    Medicine.2024; 103(29): e39037.     CrossRef
  • Bacterial pathogens in pediatric appendicitis: a comprehensive retrospective study
    Julia Felber, Benedikt Gross, Arend Rahrisch, Eric Waltersbacher, Evelyn Trips, Percy Schröttner, Guido Fitze, Jurek Schultz
    Frontiers in Cellular and Infection Microbiology.2023;[Epub]     CrossRef
  • An Update on Acute Appendicitis in Lebanon: Insights From a Single-Center Retrospective Study
    Nagham Bazzi, Samer Dbouk, Ahmad Rached, Sadek Jaber, Hala Bazzi, Manal Jrad, Mariam Bazzi
    Cureus.2023;[Epub]     CrossRef
  • Bacterial peritonitis in paediatric appendicitis; microbial epidemiology and antimicrobial management
    Keir Bhaskar, Simon Clarke, Luke S. P. Moore, Stephen Hughes
    Annals of Clinical Microbiology and Antimicrobials.2023;[Epub]     CrossRef
  • Aerobic Intraoperative Abdominal Cavity Culture Modifies Antibiotic Therapy and Reduces the Risk of Surgical Site Infection in Complicated Appendicitis with Peritonitis
    Víctor Manuel Quintero-Riaza, Romario Chancí-Drago, Natalia Guzmán-Arango, Pablo Posada-Moreno, Tatiana López-Sandoval, Isabel Cristina Ramírez-Sánchez, Johanna Marcela Vanegas-Munera
    Journal of Gastrointestinal Surgery.2023; 27(11): 2563.     CrossRef
  • Does the Covid-19 pandemic have an effect on wound culture in patients undergoing appendectomy? A Case Control Study
    Hacı BOLAT, Tuğba AVAN MUTLU
    Journal of Contemporary Medicine.2022; 12(2): 332.     CrossRef
  • Are We Hitting the Target?
    Julia Elrod, Fatima Yarmal, Christoph Mohr, Martin Dennebaum, Michael Boettcher, Deirdre Vincent, Konrad Reinshagen, Ingo Koenigs
    Pediatric Infectious Disease Journal.2022; 41(6): 460.     CrossRef
  • Is Routine Intra-operative Gram Stain, Culture, and Sensitivity during an Appendectomy is Effective in Decreasing the Rate of Post-operative Infective Complications?
    Muqdad Fuad, Ahmed Modher, Mohammed Habash
    Open Access Macedonian Journal of Medical Sciences.2022; 10(B): 868.     CrossRef
  • Die Bedeutung mikrobiologischer Ergebnisse für die Therapie der komplizierten Appendizitis – eine monozentrische Fall-Kontroll-Studie
    F-X. Anzinger, K. Rothe, S. Reischl, C. Stöss, A. Novotny, D. Wilhelm, H. Friess, P-A. Neumann
    Die Chirurgie.2022; 93(10): 986.     CrossRef
  • Implications of bacteriological study in complicated and uncomplicated acute appendicitis
    Sorin Cimpean, Alberto Gonzalez Barranquero, Ion Surdeanu, Benjamin Cadiere, Guy-Bernard Cadiere
    Annals of Coloproctology.2022;[Epub]     CrossRef
  • Do Cultures from Percutaneously Drained Intra-abdominal Abscesses Change Treatment: A Retrospective Review
    Andrew C. Esposito, Yuqi Zhang, Nupur Nagarkatti, William D. Laird, Nathan A. Coppersmith, Vikram Reddy, Ira Leeds, Anne Mongiu, Walter Longo, Ritche M. Hao, Haddon Pantel
    Diseases of the Colon & Rectum.2022;[Epub]     CrossRef
Benign GI diease
Irrigation Versus Suction Alone During Laparoscopic Appendectomy for Uncomplicated Acute Appendicitis
Tae Gyeong Lee, Soomin Nam, Hyung Soon Lee, Jin Ho Lee, Young Ki Hong, Jung Gu Kang
Ann Coloproctol. 2020;36(1):30-34.   Published online February 29, 2020
DOI: https://doi.org/10.3393/ac.2019.06.25
  • 4,516 View
  • 128 Download
  • 4 Web of Science
  • 6 Citations
AbstractAbstract PDF
Purpose
To compare the surgical outcomes of peritoneal irrigation versus suction alone during laparoscopic appendectomy and to identify the risk factors of surgical site infection in patients with uncomplicated acute appendicitis.
Methods
Data from patients with uncomplicated acute appendicitis between January 2014 and March 2016 were reviewed. We compared the irrigation and suction alone groups with regard to the following parameters: postoperative complication incidence rate, length of hospital stay, operation time, time to flatus, time to diet commencement, and duration of postoperative antibiotic.
Results
A total of 578 patients underwent laparoscopic appendectomy for uncomplicated acute appendicitis. Twenty-five patients were excluded from the analysis because of need for drain insertion, loss to follow-up, simultaneous surgery for another indication, presence of an appendix tumor, or pregnancy. A total of 207 patients (37.4%) had undergone irrigation, and 346 patients (62.6%) received suction alone during laparoscopic appendectomy. The preoperative fever rate was significantly higher in the irrigation group than in the suction alone group. Operative time was also significantly longer in the irrigation group than in the suction alone group (53.8 ± 18.5 minutes vs. 57.8 ± 21.4 minutes, P = 0.027). The postoperative complication rate was higher in the irrigation group than in the suction alone group (4.5% vs. 12.6%, P = 0.001). Multiple logistic regression analysis showed that irrigation and preoperative fever were risk factors for surgical site infection after laparoscopic appendectomy for uncomplicated acute appendicitis.
Conclusion
There is no advantage to irrigating the peritoneal cavity over suction alone during laparoscopic appendectomy for uncomplicated acute appendicitis. Irrigation may actually prolong the operative time and therefore be detrimental.

Citations

Citations to this article as recorded by  
  • Management of appendicitis: appendicectomy, antibiotic therapy, or both?
    Elroy P. Weledji, Anutebeh V. Zisuh, Eleanore Ngounou
    Annals of Medicine & Surgery.2023; 85(4): 897.     CrossRef
  • Wound Irrigation Using Wet Gauze May Reduce Surgical Site Infection Following Laparoscopic Appendectomy
    Abdullah Al-Sawat, Ji Yeon Mun, Sung Hoon Yoon, Chul Seung Lee
    Frontiers in Surgery.2022;[Epub]     CrossRef
  • To Reduce the Incidence of Postoperative Intraabdominal Abscess, the Application of Nonoperative Management Should be Circumspect Considering Patient Factors and the Nature of Acute Appendicitis
    You Jin Lee, Kwang Hyun Yoon
    Journal of Acute Care Surgery.2022; 12(3): 111.     CrossRef
  • Effect and safety of peritoneal lavage for appendectomy: A meta-analysis
    Yi-Ting Yen, El-Wui Loh, Ka-Wai Tam
    The Surgeon.2021; 19(6): e430.     CrossRef
  • A Novel Suction-and-Irrigation Laparoscopic Surgical Instrument: Internal Design and Preclinical Performance Evaluation
    Sang Wook Yi
    Journal of Medical Devices.2021;[Epub]     CrossRef
  • Aspiration versus peritoneal lavage in appendicitis: a meta-analysis
    Gloria Burini, Maria Chiara Cianci, Marco Coccetta, Alessandro Spizzirri, Salomone Di Saverio, Riccardo Coletta, Paolo Sapienza, Andrea Mingoli, Roberto Cirocchi, Antonino Morabito
    World Journal of Emergency Surgery.2021;[Epub]     CrossRef
Malignant disease
Increased Risk of Neoplasms in Adult Patients Undergoing Interval Appendectomy
Jungtak Son, Yong Jun Park, Sung Ryol Lee, Hyung Ook Kim, Kyung Uk Jung
Ann Coloproctol. 2020;36(5):311-315.   Published online January 31, 2020
DOI: https://doi.org/10.3393/ac.2019.10.15.1
  • 5,242 View
  • 202 Download
  • 9 Web of Science
  • 8 Citations
AbstractAbstract PDF
Purpose
The low rate of recurrent appendicitis after initial nonsurgical management of complicated appendicitis supports the recently implemented strategy of omitting routine interval appendectomy. However, several reports have suggested an increased incidence rate of neoplasms in these patients. We aimed to identify the risk of neoplasms in the population undergoing interval appendectomy.
Methods
This study retrospectively analyzed consecutive cases of appendicitis that were treated surgically between January 2014 and December 2018 at a single tertiary referral center. Patients were divided into 2 groups depending on whether they underwent immediate or interval appendectomy. Demographics and perioperative clinical and pathologic parameters were analyzed.
Results
All 2,013 adults included in the study underwent surgical treatment because of an initial diagnosis of acute appendicitis. Of these, 5.5% (111 of 2,013) underwent interval appendectomy. Appendiceal neoplasm was identified on pathologic analysis in 36 cases (1.8%). The incidence of neoplasm in the interval group was 12.6% (14 of 111), which was significantly higher than that of the immediate group (1.2% [22 of 1,902], P < 0.001). Conclusion: The incidence rate of neoplasms was significantly higher in patients undergoing interval appendectomy. These findings should be considered when choosing treatment options after successful nonsurgical management of complicated appendicitis.

Citations

Citations to this article as recorded by  
  • Can Appendiceal Neoplasms Be Predicted in Patients with Presumed Acute Appendicitis?
    Şevki Pedük
    European Journal of Therapeutics.2024; 30(2): 145.     CrossRef
  • Beyond acute appendicitis: a single-institution experience of unexpected pathology findings after 989 consecutive emergency appendectomy
    Pietro Fransvea, Caterina Puccioni, Gaia Altieri, Luca D’Agostino, Gianluca Costa, Giuseppe Tropeano, Antonio La Greca, Giuseppe Brisinda, Gabriele Sganga
    Langenbeck's Archives of Surgery.2024;[Epub]     CrossRef
  • Exploring the mysterious mucinous appendiceal neoplasm
    Erika Hissong
    Seminars in Diagnostic Pathology.2024; 41(5): 222.     CrossRef
  • High Incidence of Appendiceal Neoplasms in the Elderly: A Critical Concern for Non-Surgical Treatment
    Gizem Issin, Fatih Demir, Irem Guvendir Bakkaloglu, Diren Vuslat Cagatay, Hasan Aktug Simsek, Ismail Yilmaz, Ebru Zemheri
    Medical Principles and Practice.2023; 32(6): 358.     CrossRef
  • Benign multicystic mesothelioma of appendiceal origin treated by hyperthermic intraperitoneal chemotherapy: A case report
    Suk Jun Lee, Ji Hae Nahm, Jeonghyun Kang, Seung Hyuk Baik, Eun Jung Park
    International Journal of Surgery Case Reports.2022; 99: 107665.     CrossRef
  • Risk of appendiceal neoplasm after interval appendectomy for complicated appendicitis: A systematic review and meta-analysis
    Roberto Peltrini, Valeria Cantoni, Roberta Green, Ruggero Lionetti, Michele D'Ambra, Carolina Bartolini, Marcello De Luca, Umberto Bracale, Alberto Cuocolo, Francesco Corcione
    The Surgeon.2021; 19(6): e549.     CrossRef
  • Interval appendicectomy for complicated appendicitis: do not let your guard down!
    R Peltrini, M Podda, S Di Saverio, U Bracale, F Corcione
    British Journal of Surgery.2021; 108(9): e288.     CrossRef
  • Modern Management of the Appendix
    CPT Samuel Grasso, LTC Avery Walker
    Surgical Clinics of North America.2021; 101(6): 1023.     CrossRef
Is a One Night Delay of Surgery Safe in Patients With Acute Appendicitis?
Jae Min Lee, Beom Seok Kwak, Young Jin Park
Ann Coloproctol. 2018;34(1):11-15.   Published online February 28, 2018
DOI: https://doi.org/10.3393/ac.2018.34.1.11
  • 5,668 View
  • 129 Download
  • 21 Web of Science
  • 17 Citations
AbstractAbstract PDF
Purpose

With varied reports on the impact of time to appendectomy on clinical outcomes, the purpose of this study was to determine the effect of preoperative in-hospital delay on the outcome for patients with acute appendicitis.

Methods

A retrospective review of 1,076 patients who had undergone an appendectomy between January 2010 and December 2013 was conducted.

Results

The outcomes of surgery and the pathologic findings were analyzed according to elapsed time. The overall elapsed time from onset of symptoms to surgery was positively associated with advanced pathology, increased number of complications, and prolonged hospital stay. In-hospital elapsed time was not associated with any advanced pathology (P = 0.52), increased number of postoperative complications (P = 0.14), or prolonged hospital stay (P = 0.24). However, the complication rate was increased when the in-hospital elapsed time exceeded 18 hours.

Conclusion

Advanced pathology and postoperative complication rate were associated with overall elapsed time from symptom onset to surgery rather than in-hospital elapse time. Therefore, a short-term delay of an appendectomy should be acceptable.

Citations

Citations to this article as recorded by  
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    Oliver Claydon, Billy Down, Sidharth Kumar
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    Tomoya Tago, Mitsugi Shimoda, Ryosuke Imazato, Ryutaro Udou, Kenji Katsumata, Akihiko Tsuchida, Shuji Suzuki
    Asian Journal of Endoscopic Surgery.2022; 15(1): 22.     CrossRef
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    Jian Li
    World Journal of Clinical Cases.2021; 9(20): 5372.     CrossRef
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Which One is Better? Comparison of the Acute Inflammatory Response, Raja Isteri Pengiran Anak Saleha Appendicitis and Alvarado Scoring Systems
Mohammad Yasin Karami, Hadi Niakan, Navid Zadebagheri, Parviz Mardani, Zahra Shayan, Iman Deilami
Ann Coloproctol. 2017;33(6):227-231.   Published online December 31, 2017
DOI: https://doi.org/10.3393/ac.2017.33.6.227
  • 5,867 View
  • 112 Download
  • 24 Web of Science
  • 22 Citations
AbstractAbstract PDF
Purpose

Acute appendicitis (AA) is one of the most common causes of an acute abdomen. The accuracies of the Alvarado and the acute inflammatory response (AIR) scores in the diagnosis of appendicitis is very low in Asian populations, so a new scoring system, the Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) system, was designed recently. We applied and compared the Alvarado, AIR, and RIPASA scores in the diagnoses of appendicitis in the Iranian population.

Methods

We prospectively compared the RIPASA, Alvarado, and AIR systems by applying them to 100 patients. All the scores were calculated for patients who presented with right quadrant pain. Appendectomies were performed; then, the postoperative pathology reports were correlated with the scores. Scores of 8, 7, and 5 or more are optimal cutoffs for the RIPASA, Alvarado, and AIR scoring systems, respectively. The sensitivities, specificities, positive predictive values, negative predictive values (NPVs), positive and negative likelihood ratios (LRs) for the 3 systems were determined.

Results

The sensitivity and the specificity of the RIPASA score were 93.18% and 91.67%, respectively. The sensitivities of the Alvarado and the AIR scores were both 78.41%. The specificities of the Alvarado and the AIR scores were 100% and 91.67%, respectively. The RIPASA score correctly classified 93% of all patients confirmed with histological AA compared with 78.41% for the Alvarado and the AIR scores.

Conclusion

The RIPASA scoring system had more sensitivity, better NPV, a positive LR, and a less negative LR for the Iranian population whereas the Alvarado scoring system was more specific.

Citations

Citations to this article as recorded by  
  • Evaluating the Diagnostic Accuracy of the Alvarado Score and Abdominal Ultrasound for Acute Appendicitis: A Retrospective Single-Center Study
    Saleh Al-wageeh, Qasem Alyhari, Faisal Ahmed, Abdulfattah Altam, Gubran Alshehari, Mohamed Badheeb
    Open Access Emergency Medicine.2024; Volume 16: 159.     CrossRef
  • EVALUATION OF ALVARADO SCORE IN DIAGNOSIS OF ACUTE APPENDICITIS
    Sumia Dra
    Libyan Journal of Medical Research.2024; 18(1): 172.     CrossRef
  • Comparison of Alvarado score, appendicitis inflammatory response score (AIR) and Raja Isteri Pengiran Anak Saleha appendicitis (RIPASA) score in predicting acute appendicitis
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    Heliyon.2023; 9(1): e13013.     CrossRef
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    Sapna Gupta, Venkata S. Kolli, Kimberly Da Costa, Sariya Javed, Ahmed Ammar, Ashraf Rasheed
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    Pedro Josué Araujo Ramírez, Ricardo Sanabria Trujillo, Sergio Hernández Aguilar, Francisco Javier Hernández Hernández
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    Emre Gonullu, Zulfu Bayhan, Recayi Capoglu, Barış Mantoglu, Burak Kamburoglu, Tarık Harmantepe, Fatih Altıntoprak, Unal Erkorkmaz, Roberto Cirocchi
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    Eleonora Guaitoli, Gaetano Gallo, Eleonora Cardone, Luigi Conti, Simone Famularo, Giampaolo Formisano, Federica Galli, Giuseppe Giuliani, Antonio Martino, Alessandro Pasculli, Romeo Patini, Domenico Soriero, Vincenzo Pappalardo, Gianmaria Casoni Pattacini
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    Manne Andersson, Blanka Kolodziej, Roland E. Andersson
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    Nurullah Damburacı, Barış Sevinç, Murat Güner, Ömer Karahan
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  • COMPARİSON OF ALVARADO AND RIPASA SCORES İN PATİENTS WİTH ACUTE APPENDİCİTİS
    Mine ESMER GÖKÇE, İ̇lhan KORKMAZ, Yusuf TEKİN, Sefa YURTBAY, Erdal DEMİRTAŞ, Orhan ÖZSOY, Sedat ÖZBAY, Fatma KUKUL GÜVEN
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  • Predictive Value of Alvarado, Acute Inflammatory Response, Tzanakis and RIPASA Scores in the Diagnosis of Acute Appendicitis
    Senol Tahir, Andrej Nikolovski, Martina Ambardjieva, Petar Markov, Dragoslav Mladenovik, Gjulsen Selim, Beti Zafirova-Ivanovska, Vlado Janevski
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    Aditya Vijay Mundada, Yeshwant Lamture, Meenakshi Yeola
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    Banu Karapolat
    Emergency Medicine International.2019; 2019: 1.     CrossRef
Unexpected Appendiceal Pathologies and Their Changes With the Expanding Use of Preoperative Imaging Studies
Hong Yeol Yoo, Jaewoo Choi, Jongjin Kim, Young Jun Chai, Rumi Shin, Hye Seong Ahn, Chang-Sup Lim, Hae Won Lee, Ki-Tae Hwang, In Mok Jung, Jung Kee Chung, Seung Chul Heo
Ann Coloproctol. 2017;33(3):99-105.   Published online June 30, 2017
DOI: https://doi.org/10.3393/ac.2017.33.3.99
  • 3,921 View
  • 49 Download
  • 5 Web of Science
  • 6 Citations
AbstractAbstract PDF
Purpose

The preoperative diagnosis of acute appendicitis is often challenging. Sometimes, pathologic results of the appendix embarrass or confuse surgeons. Therefore, more and more imaging studies are being performed to increase the accuracy of appendicitis diagnoses preoperatively. However, data on the effect of this increase in preoperative imaging studies on diagnostic accuracy are limited. We performed this study to explore unexpected appendiceal pathologies and to delineate the role of preoperative imaging studies in the diagnosis of acute appendicitis.

Methods

The medical records of 4,673 patients who underwent an appendectomy for assumed appendicitis between 1997 and 2012 were reviewed retrospectively. Pathological results and preoperative imaging studies were surveyed, and the frequencies of pathological results and preoperative imaging studies were investigated.

Results

The overall rate of pathology compatible with acute appendicitis was 84.4%. Unexpected pathological findings, such as normal histology, specific inflammations other than acute appendicitis, neoplastic lesions, and other pathologies, comprised 9.6%, 3.3%, 1.2%, and 1.5%, respectively. The rate of unexpected pathological results was significantly reduced because of the increase in preoperative imaging studies. The decrease in normal appendices contributed the most to the reduction while other unexpected pathologies did not change significantly despite the increased use of imaging studies. This decrease in normal appendices was significant in both male and female patients under the age of 60 years, but the differences in females were more prominent.

Conclusion

Unexpected appendiceal pathologies comprised 15.6% of the cases. Preoperative imaging studies reduced them by decreasing the negative appendectomy rate of patients with normal appendices.

Citations

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  • The appendix: An unexpected band obstruction
    Rowan Klein Nulend, Rakesh Quinn, Kar Yin Fok, Nimalan Pathmanathan
    Journal of Case Reports and Images in Surgery.2024; 10(1): 1.     CrossRef
  • The Vermiform Appendix and Its Pathologies
    Marian Constantin, Livia Petrescu, Cristina Mătanie, Corneliu Ovidiu Vrancianu, Adelina-Gabriela Niculescu, Octavian Andronic, Alexandra Bolocan
    Cancers.2023; 15(15): 3872.     CrossRef
  • Rising incidence of appendiceal neoplasms over time: Does pathological handling of appendectomy specimens play a role?
    Hisham F. Bahmad, Abed Alhalim Aljamal, Juan Carlos Alvarez Moreno, Ali Salami, Philip Bao, Sarah Alghamdi, Robert J. Poppiti
    Annals of Diagnostic Pathology.2021; 52: 151724.     CrossRef
  • The Impact of Pathological Criteria on Pediatric Negative Appendectomy Rate
    Caroline Maloney, Morris C. Edelman, Alexandra C. Bolognese, Aaron M. Lipskar, Barrie S. Rich
    Journal of Pediatric Surgery.2019; 54(9): 1794.     CrossRef
  • Communication and management of incidental pathology in 1,214 consecutive appendicectomies; a cohort study
    Ned Kinnear, Bridget Heijkoop, Eliza Bramwell, Alannah Frazzetto, Amy Noll, Prajay Patel, Derek Hennessey, Greg Otto, Christopher Dobbins, Tarik Sammour, James Moore
    International Journal of Surgery.2019; 72: 185.     CrossRef
  • Unexpected Appendiceal Pathologies and Preoperative Imaging Studies on Patients With Acute Appendicitis
    Byung Chun Kim
    Annals of Coloproctology.2017; 33(3): 82.     CrossRef
Single-Port Laparoscopic Interval Appendectomy for Perforated Appendicitis With a Periappendiceal Abscess
Sung Uk Bae, Woon Kyung Jeong, Seong Kyu Baek
Ann Coloproctol. 2016;32(3):105-110.   Published online June 30, 2016
DOI: https://doi.org/10.3393/ac.2016.32.3.105
  • 5,782 View
  • 66 Download
  • 5 Web of Science
  • 8 Citations
AbstractAbstract PDF
Purpose

Nonoperative management followed by an interval appendectomy is a commonly used approach for treating patients with perforated appendicitis with abscess formation. As minimally-invasive surgery has developed, single-port laparoscopic surgery (SPLS) is increasingly being used to treat many conditions. We report our initial experience with this procedure using a multichannel single-port.

Methods

The study included 25 adults who underwent a single-port laparoscopic interval appendectomy for perforated appendicitis with periappendiceal abscess by using a single-port with or without needlescopic grasper between June 2014 and January 2016.

Results

Of the 25 patients, 9 (36%) required percutaneous drainage for a median of 7 days (5–14 days) after insertion, and 3 (12%) required conversion to reduced-port laparoscopic surgery with a 5-mm port insertion because of severe adhesions to adjacent organs. Of 22 patients undergoing SPLS, 13 underwent pure SPLS (52.0%) whereas 9 patients underwent SPLS with a 2-mm needle instrument (36.0%). Median operation time was 70 minutes (30–155 minutes), and a drainage tube was placed in 9 patients (36.0%). Median total length of incision was 2.5 cm (2.0–3.0 cm), and median time to soft diet initiation and length of stay in the hospital were 2 days (0–5 days) and 3 days (1–7 days), respectively. Two patients (8.0%) developed postoperative complications: 1 wound site bleeding and 1 surgical site infection.

Conclusion

Conservative management followed by a single-port laparoscopic interval appendectomy using a multichannel single-port appears feasible and safe for treating patients with acute perforated appendicitis with periappendiceal abscess.

Citations

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    Kyeong Eui Ki, Yu Ra Jeon, Sung Uk Bae, Woon Kyung Jeong, Seong Kyu Baek
    Journal of Minimally Invasive Surgery.2024; 27(1): 14.     CrossRef
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    Sung Uk Bae, Woon Kyung Jeong, Seong Kyu Baek
    Journal of Minimal Access Surgery.2023; 19(1): 168.     CrossRef
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    Andrés Felipe Carrillo Montenegro, Sofía Aristizabal Rojas, Jean André Pulido Segura, Mauricio Pedraza, Laura Padilla, Ivan David Lozada-Martinez, Alexis Rafael Narvaez-Rojas, Luis Felipe Cabrera-Vargas
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    Kyeong Eui Kim, In Soo Cho, Sung Uk Bae, Woon Kyung Jeong, Hyung Jin Kim, Seong Kyu Baek
    Journal of Minimally Invasive Surgery.2023; 26(2): 55.     CrossRef
  • Actinomycosis of the Appendix Mimicking Cecal Tumor Treated by Single-Port Laparoscopic Approach
    In Soo Cho, Sung Uk Bae, Hye Ra Jung, Kyung Sik Park, Woon Kyung Jeong, Seong Kyu Baek
    Annals of Coloproctology.2021; 37(2): 125.     CrossRef
  • Single-incision Laparoscopy-assisted Appendectomy in the Pediatric Age Group: Our Experience
    Hemanshi Shah, Charu Tiwari, Suraj Gandhi, Gursev Sandlas, Neha Sisodiya Shenoy
    World Journal of Laparoscopic Surgery with DVD.2020; 13(2): 77.     CrossRef
  • Clinical outcomes of single‐site laparoscopic interval appendectomy for severe complicated appendicitis: Comparison to conventional emergency appendectomy
    Masaaki Miyo, Shoichiro Urabe, Satoshi Hyuga, Tomo Nakagawa, Toshiya Michiura, Nobuyasu Hayashi, Kazuo Yamabe
    Annals of Gastroenterological Surgery.2019; 3(5): 561.     CrossRef
  • Minimally Invasive Interval Appendectomy for Perforated Appendicitis With a Periappendiceal Abscess
    Ik Yong Kim
    Annals of Coloproctology.2016; 32(3): 88.     CrossRef

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