Peritonitis from Perforated Appendicitis: Stress Response after Laparoscopic or Open Treatment

2012 ◽  
Vol 78 (5) ◽  
pp. 582-590 ◽  
Author(s):  
Mario Schietroma ◽  
Federica Piccione ◽  
Francesco Carlei ◽  
Marco Clementi ◽  
Zuleyka Bianchi ◽  
...  
Keyword(s):  
Systemic Inflammation ◽  
Laparoscopic Appendectomy ◽  
Neutrophil Elastase ◽  
Open Appendectomy ◽  
Perforated Appendicitis ◽  
Laparoscopic Group ◽  
Open Group ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Hla Dr

Elevated intra-abdominal pressure during laparoscopy may promote systemic inflammatory response. In patients with generalized peritonitis from perforated appendicitis, we sought to compare acute phase response and immunologic status from laparoscopic and open approach. One hundred and forty-seven consecutive patients underwent appendectomy for perforated appendicitis (73 patients had laparoscopic appendectomy and 74 patients had open appendectomy. Bacteremia, endotoxemia, white blood cells, peripheral lymphocytes subpopulation, human leukocyte antigen-DR (HLA-DR), neutrophil-elastase, interleukin-1 and 6 (IL-1 and 6), and C-reactive protein were investigated. One hour after intervention, bacteremia was significantly higher in the open group compared with the laparoscopic group ( P < 0.05). A significantly higher concentration of systemic endotoxin was detected intraoperatively in the open group of patients in comparison with the laparoscopic group ( P < 0.05). Laparotomy caused a significant increase in neutrophil concentration, neutrophil-elastase, IL-1 and 6, and C-reactive protein and a decrease of HLA-DR. We recorded 6 cases (8.1%) of intra-abdominal abscess in the open group and one (1.3%) in the laparoscopic group ( P < 0.05). Open appendectomy, in case of peritonitis, increased the incidence of bacteremia, endotoxemia, and systemic inflammation compared with laparoscopic appendectomy. Early enhanced postoperative systemic inflammation may cause lower transient immunologic defense after laparotomy (decrease of HLA-DR), leading to enhanced sepsis in these patients.

scholarly journals Appendectomized Patient and Infections after Surgery

2016 ◽  
Vol 9 (1) ◽  
pp. 46
Author(s):  
Mohammad Reza Asgary ◽  
Hosein Hemmati
Keyword(s):  
Postoperative Complications ◽  
Abdominal Surgery ◽  
Laparoscopic Appendectomy ◽  
Open Appendectomy ◽  
Google Scholar ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
The World ◽  
Perforated Appendix ◽  
The Common

Appendicitis is one of the common surgeries all over the world, and its diagnosis is difficult and based on clinical examinations or its symptoms. Moreover, after the surgery is accomplished, it is probable that the patient is faced with certain problems and complications. In this regard, the present study was carried out in order to review the infections caused after appendicitis surgery. The databases like PubMed, Google Scholar, and Science Direct and relevant articles were collected, in which keywords like appendicitis surgery, perforation, laparoscopy, and infection had been used. A total number of 6,000 articles were retrieved, out of which, 74 relevant articles were examined. The results of the present study indicated that perforated appendix can be the biggest cause of infection and abscess after intra-abdominal surgery. An increase in the level of C-reactive protein and leukocytes is accompanied with the risk of postoperative complications including infection and abscess. Numerous studies have reported that formation of infection and abscess after laparoscopic appendectomy is a little more than open appendectomy. It is not necessary to consume antibiotics after a non-perforated appendectomy. It is sufficient to consume antibiotics for 3 to 5 days after a perforated appendectomy to prevent infection and abscess. With the above results now it is evident that the appendicitis and its complications are still a common problem among people all over the world. There is still much to discuss among the surgeons with regards to appendicitis and its complications.

scholarly journals Appendectomized Patient and Infections after Surgery

2016 ◽  
Vol 9 (1) ◽  
pp. 46
Author(s):  
Mohammad Reza Asgary ◽  
Hosein Hemmati
Keyword(s):  
Postoperative Complications ◽  
Abdominal Surgery ◽  
Laparoscopic Appendectomy ◽  
Open Appendectomy ◽  
Google Scholar ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
The World ◽  
Perforated Appendix ◽  
The Common

Appendicitis is one of the common surgeries all over the world, and its diagnosis is difficult and based on clinical examinations or its symptoms. Moreover, after the surgery is accomplished, it is probable that the patient is faced with certain problems and complications. In this regard, the present study was carried out in order to review the infections caused after appendicitis surgery. The databases like PubMed, Google Scholar, and Science Direct and relevant articles were collected, in which keywords like appendicitis surgery, perforation, laparoscopy, and infection had been used. A total number of 6,000 articles were retrieved, out of which, 74 relevant articles were examined. The results of the present study indicated that perforated appendix can be the biggest cause of infection and abscess after intra-abdominal surgery. An increase in the level of C-reactive protein and leukocytes is accompanied with the risk of postoperative complications including infection and abscess. Numerous studies have reported that formation of infection and abscess after laparoscopic appendectomy is a little more than open appendectomy. It is not necessary to consume antibiotics after a non-perforated appendectomy. It is sufficient to consume antibiotics for 3 to 5 days after a perforated appendectomy to prevent infection and abscess. With the above results now it is evident that the appendicitis and its complications are still a common problem among people all over the world. There is still much to discuss among the surgeons with regards to appendicitis and its complications.

scholarly journals Complications after Laparoscopic Appendectomy for Complicated Appendicitis

2020 ◽  
Vol 19 (1-2) ◽  
pp. 34-41
Author(s):  
Andrej Nikolovski ◽  
Shenol Tahir ◽  
Dragoslav Mladenovikj
Keyword(s):  
Postoperative Complications ◽  
Wound Infection ◽  
Laparoscopic Appendectomy ◽  
Operative Time ◽  
Open Appendectomy ◽  
Laparoscopic Group ◽  
Complicated Appendicitis ◽  
Open Group ◽  
Uncomplicated Appendicitis ◽  
Low Incidence

Background. Laparoscopic appendectomy is established method in the treatment of complicated appendicitis. Certain advantages of the technique do not fulfill the expectations for its superiority over the open appendectomy as when it is used for uncomplicated appendicitis. This is generally caused because of the high variety of postoperative complications reported in different series for complicated appendicitis. Material and methods. This prospective interventional clinical study analyzes 61 patients operated with laparoscopic and open appendectomy due to complicated appendicitis, with an end point of comparing the intra and postoperative complications in both groups. Results. Conversion in open appendectomy was forced in one patient (1.63%). The operative time was significantly shorter in the laparoscopic group (p = 0.048). Wound infection was significantly predominant in the open group (p = 0.045). Postoperative intraabdominal abscess occurred in one patient in the laparoscopic group (p = 0.52). The overall morbidity was 26.2% (7 patients in the laparoscopic, and 9 in the open group; p = 0.59). Length of stay was significantly shorter in the laparoscopic group (p = 0.00001). Conclusion. Certain significant advantages of the laparoscopic appendectomy as low incidence of wound infection, short hospitalization, less postoperative pain and faster socialization makes the laparoscopy up to date method in the treatment of complicated appendicitis.

scholarly journals Appendectomized Patient and Infections after Surgery

2016 ◽  
Vol 8 (1) ◽  
pp. 36
Author(s):  
Mohammad Reza Asgary ◽  
Hosein Hemmati
Keyword(s):  
Postoperative Complications ◽  
Abdominal Surgery ◽  
Laparoscopic Appendectomy ◽  
Open Appendectomy ◽  
Google Scholar ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
The World ◽  
Perforated Appendix ◽  
The Common

Appendicitis is one of the common surgeries all over the world, and its diagnosis is difficult and based on clinical examinations or its symptoms. Moreover, after the surgery is accomplished, it is probable that the patient is faced with certain problems and complications. In this regard, the present study was carried out in order to review the infections caused after appendicitis surgery. The databases like PubMed, Google Scholar, and Science Direct and relevant articles were collected, in which keywords like appendicitis surgery, perforation, laparoscopy, and infection had been used. A total number of 6,000 articles were retrieved, out of which, 74 relevant articles were examined. The results of the present study indicated that perforated appendix can be the biggest cause of infection and abscess after intra-abdominal surgery. An increase in the level of C-reactive protein and leukocytes is accompanied with the risk of postoperative complications including infection and abscess. Numerous studies have reported that formation of infection and abscess after laparoscopic appendectomy is a little more than open appendectomy. It is not necessary to consume antibiotics after a non-perforated appendectomy. It is sufficient to consume antibiotics for 3 to 5 days after a perforated appendectomy to prevent infection and abscess. With the above results now it is evident that the appendicitis and its complications are still a common problem among people all over the world. There is still much to discuss among the surgeons with regards to appendicitis and its complications.

scholarly journals Changes in levels of C-reactive protein in open appendectomy compared to laparoscopic appendectomy

2012 ◽  
Vol 3 ◽  
pp. 156-160
Author(s):  
Shahnam Askarpour ◽  
Mehdi Asgari ◽  
Solmaz Hashemi ◽  
Hazhir Javaherizadeh
Keyword(s):  
Laparoscopic Appendectomy ◽  
Open Appendectomy ◽  
C Reactive Protein ◽  
Reactive Protein

scholarly journals Predictive factors of perforated appendicitis: Impact of the C-reactive protein level

2021 ◽  
Author(s):  
Shiori Yamazaki ◽  
Yusuke Shimodaira ◽  
Akira Kobayashi ◽  
Manabu Takata ◽  
Kaori Hayashibara ◽  
...  
Keyword(s):  
Predictive Factors ◽  
Protein Level ◽  
Perforated Appendicitis ◽  
C Reactive Protein ◽  
Reactive Protein

scholarly journals Evaluation of Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and C-Reactive Protein in Tension-Type Headache Patients

2021 ◽  
Author(s):  
Hasan Hüseyin Özdemir ◽  
Ahmet Dönder
Keyword(s):  
Systemic Inflammation ◽  
Tension Type Headache ◽  
Neutrophil To Lymphocyte Ratio ◽  
Control Group ◽  
C Reactive Protein ◽  
Platelet To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Reactive Protein ◽  
Significant Difference ◽  
Type Headache

Abstract Objectives A tension headache is the most common type of headache, and its causes are multifactorial. A relationship has been shown between migraine headaches and neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and C-reactive protein (CRP). In this study, we investigated the NLR, PLR, and serum CRP levels in frequent episodic tension-type headache (FETTH) and chronic tension-type headache (CTTH) patients. Materials and Methods This retrospective study included 64 patients with FETTH, 80 patients with CTTH, and 60 healthy controls who were followed up in the neurology clinic. Hematological parameters were compared between the patient and control groups. Results In CTTH patients, platelets, NLR, PLR, and CRP values were statistically higher than in FETTH patients and patients in the control group. In FETTH patients, the PLR value was higher than in patients in the control group, but there was no statistically significant difference in NLR and CRP values between FETTH patients and patients in the control group. Also, there was no correlation between these values and age and gender. Conclusion Increase platelet count might have an effect on tension-type headache pathophysiology. Systemic inflammation parameters were shown to be significantly higher in CTTH patients. More comprehensive studies are needed to evaluate the effect of systemic inflammation on the chronicity of tension headaches.

Association of Wound Infection with Various Surgical Technique Applied for Appendectomy in Diabetic and Hypertensive Patients

2021 ◽  
Vol 15 (8) ◽  
pp. 2163-2165
Author(s):  
Muhammad Armughan ◽  
Imran Sadiq ◽  
Shafqat Mukhtar ◽  
Hafiz Ahmad Altaf
Keyword(s):  
Wound Infection ◽  
Laparoscopic Appendectomy ◽  
Surgical Procedure ◽  
Open Appendectomy ◽  
Perforated Appendicitis ◽  
Diabetic Patients ◽  
Wound Infections ◽  
Hypertensive Patients ◽  
Duration Of Surgery ◽  
Perforated Appendix

Background: Perforated appendix in diabetic as well as hypertensive patients is associated with elevated risks of postoperative infectious complications such as wound infection and intra-abdominal abscess. Objective: To identify better appendectomy procedure for diabetic and hypertensive patients. Study Design: Randomized Controlled Trial Place and Duration of Study: Department of Surgery, Unit l, Bahawal Victoria Hospital Bahawalpur from 10th October 2020 to 9th April 2021. Methodology: Ninety eight patients meeting the criteria of perforated appendix were divided in two groups; one group consisted of 49 patients who were managed by open surgical procedure. Second group was consisted of 49 patients who were managed by laparoscopic surgical procedure. Patient outcomes in-terms of wound infections, operative time and duration of surgery was assessed. Results: Mean age of patients was 25.49±6.03 years. There were 17 hypertensive while 15 diabetic patients. Wound infection was seen in 21% and 28% open surgery diabetic and hypertensive patients respectively in comparison to 10%and 8% in laparoscopic appendectomy diabetic and hypertensive patients respectively (p<0.001). Conclusion: Laparoscopic appendectomy (LA) is associated with significantly lower rates of post-operative wound infections and shorter hospital stay in comparison to open appendectomy in diabetic and hypertensive patients of perforated appendicitis. Key Words: Perforated appendix, laparoscopic, open appendectomy

P4679Changes in systemic inflammation and endothelial dysfunction after balloon pulmonary angioplasty

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
W Magon ◽  
J Stepniewski ◽  
K Jonas ◽  
M Waligora ◽  
P Podolec ◽  
...  
Keyword(s):  
Endothelial Dysfunction ◽  
Serum Concentration ◽  
Systemic Inflammation ◽  
Interleukin 6 ◽  
C Reactive Protein ◽  
Pulmonary Hemodynamics ◽  
Endothelin 1 ◽  
Reactive Protein ◽  
Balloon Pulmonary Angioplasty

Abstract Introduction Pulmonary endarterectomy leads to a decrease in systemic inflammation and improvement in endothelial function in patients with chronic thromboembolic pulmonary hypertension (CTEPH). Balloon pulmonary angioplasty (BPA) improves pulmonary hemodynamics in patients with inoperable CTEPH. Aim To assess changes in systemic inflammation and endothelial dysfunction after a single BPA session and after completion of the treatment. Methods We enrolled consecutive, inoperable CTEPH patients who underwent BPA. Interleukin 6, 10 (IL-6, IL-10), and C-reactive protein (hsCRP) constituted markers of systemic inflammation. Endothelin-1 (ET-1) served as a marker of endothelial dysfunction. Serum concentration of selected markers was assessed in every patient before, 24 hours after the first BPA session and 6 months after completion of the BPA treatment. Age- and sex-matched healthy subjects served as a control group. Results We recruited 20 patients with inoperable CTEPH (6 males [30%]), aged 67 [61–74] years in New York Heart Association class III (n=19 [95%]) and II (n=1 [5%]). BPA treatment was completed with a median of 5 [2–8] BPA sessions per patient. Before starting the treatment CTEPH patients, as compared to controls (n=10), had raised serum level of IL-6 (3.82 [2.75 - 6.03] vs. 2.64 [0.88 - 4.75] pg/ml; p=0.04), hsCRP (2.47 [0.93 - 4.27] vs. 1.23 [0.48–3.21] ng/ml; p=0.02) and ET-1 (2.68 [2.24 - 3.64] vs. 1.47 [1.4 - 1.82] pg/ml; p=0.004). There was no difference in IL-10 level. 24 hours after a BPA session we observed an increased level of IL-6, IL-10 and hsCRP. (Tab.) 6 months after completion of the BPA treatment there was a reduced level of IL-6, hsCRP and ET-1 (Tab.) Table 1. Changes (Δ) in serum concentration of analyzed markers 24 hours after a single BPA session and at 6-months assessment after completion of the BPA treatment (n=20) Initial Δ at 24 hours after single BPA p Δ at 6-months follow-up p ET-1 [pg/ml] 2.68 [2.24; 3.64] −0.2 [−0.5; 0.23] 0.21 −0.47 [−0.96; 0.05] 0.004 IL-6 [pg/ml] 3.82 [2.75; 6.03] 3.67 [1.41; 7.16] 0.008 −0.82 [−3.11; 0.54] 0.04 IL-10 [pg/ml] 0.53 [0.44; 0.58] 0.32 [0.21; 0.87] 0.006 −0.11 [−0.33; 0.14] 0.94 hsCRP [ng/ml] 2.47 [0.93; 4.27] 5.4 [3.96; 10.59] 0.008 −0.36 [−0.94; 0.16] 0.02 ET-1, endothelin 1; hsCRP, C-reactive protein; IL-6, interleukin 6; IL-10, interleukin 10. Conclusions Patients with inoperable CTEPH, as compared to healthy controls, exhibit an increased systemic inflammation and endothelial dysfunction, which both improve after completion of the BPA treatment. At short-term follow-up after single BPA session there is an increase in systemic inflammatory response.

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