Laparoscopic interventions in children with complicated appendicitis

The article presents an overview of laparoscopic appendectomy experience in 3,766 children with complicated appendicitis in the clinic of the Department of Paediatric Surgery of the Russian State Medical Academy of Continuous Vocational Education (Moscow). The authors showed the high efficiency of laparoscopic techniques in the operative treatment. The features of tactics in destructive appendicitis and peritonitis are highlighted.

Download Full-text

Outcomes of early surgical management of complicated appendicitis in children

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20181543 ◽

2018 ◽

Vol 5 (3) ◽

pp. 1063

Author(s):

Pramod S. ◽

B. Revanth Kumar

Keyword(s):

Surgical Management ◽

Laparoscopic Appendectomy ◽

Leucocyte Count ◽

Complicated Appendicitis ◽

Early Surgery ◽

High Morbidity ◽

Paediatric Surgery ◽

Delayed Presentation ◽

Duration Of Stay ◽

Pain Abdomen

Background: Appendicitis is the most common surgical emergency in children. Nearly 30% of children present with complicated appendicitis. Controversy exists between early or delayed surgery in complicated appendicitis. Present study was done to evaluate the outcome of early surgical management of complicated appendicitis in children and also to analyze risk factors for complicated appendicitis.Methods: A retrospective observational study conducted by the department of Paediatric Surgery, KIMS, hospital Bangalore. All children with complicated appendicitis (perforated, gangrenous and mass) from October 2014 to October 2017 were included in the study. Clinical, biochemical and imaging findings of these children were tabulated. Children underwent either open or laparoscopic appendectomy. Intra operative data regarding the type of complication, presence or absence of Fecolith, position of appendix was documented. Post operatively duration of stay and complications were analyzed.Results: 47 children were included in the study. Mean age of presentation was 10.38±2.84 years. Most common presentation was pain abdomen. 65% of the patient had pain abdomen for duration of three days or more. Total leucocyte count of more than 15000 was seen in about 50% of the children. 68% of children underwent laparotomy, 23.5% underwent laparoscopic appendectomy. Intra operatively, perforation of the appendix with generalized peritonitis was the commonest finding. Fecolith was present in 32% of the cases. Mean duration of stay was 7.46 days. Wound infection was seen in 15% of the children. Late complication in the form of adhesive obstruction was seen in 5 patients.Conclusions: Complicated appendicitis is associated with high morbidity. High leucocyte count, delayed presentation and Fecolith are possible indicators of complicated appendicitis. Early surgery in complicated appendicitis is safe, feasible. The complication rate is acceptable and most of them can be managed conservatively. Hence early surgery in complicated appendicitis is an option to be considered.

Download Full-text

Roundtable discussion: Discussion of the Russian Gastroenterological Association clinical guidelines for the diagnosis and treatment of functional disorders of the biliary tract

Medical Council ◽

10.21518/2079-701x-2018-12-83-91 ◽

2018 ◽

pp. 83-91

Author(s):

Article Editorial

Keyword(s):

Biliary Tract ◽

Clinical Guidelines ◽

Professional Training ◽

Diagnosis And Treatment ◽

Functional Disorders ◽

Roundtable Discussion ◽

National School ◽

Medical Academy ◽

Russian State ◽

State Medical Academy

The roundtable discussion was arranged within the framework of the 106th International Spring Session of the National School of Gastroenterology and Hepatology of the Russian State Medical Academy sponsored by Canonpharma Production. The purpose of the roundtable was to introduce practising physicians to the Russian Gastroenterological Association clinical guidelines for the diagnosis and treatment of functional disorders of the biliary tract. The discussion was held by the Executive Director of the National School of Gastroenterology and Hepatology of the Russian State Medical Academy, the Curriculum Director of the Course “Functional Diagnostics and Pharmacotherapy in Gastroenterology” at the Family Medicine Department of the Faculty of Postgraduate Professional Training of Physicians of I.M. Sechenov Moscow Medical Academy, Elena K. Baranskaya, MD, Professor.

Download Full-text

Antibiotic Duration After Laparoscopic Appendectomy for Acute Complicated Appendicitis

JAMA Surgery ◽

10.1001/jamasurg.2015.4236 ◽

2016 ◽

Vol 151 (4) ◽

pp. 323 ◽

Cited By ~ 31

Author(s):

Charles C. van Rossem ◽

Marc H. F. Schreinemacher ◽

Anna A. W. van Geloven ◽

Willem A. Bemelman ◽

Keyword(s):

Laparoscopic Appendectomy ◽

Complicated Appendicitis ◽

Antibiotic Duration

Download Full-text

MANAGEMENT OF ACUTE APPENDICITIS DURING THE EARLY PHASE OF THE COVID-19 PANDEMIC: A SINGLE NHS CENTRE STUDYONE YEAR FOLLOW UP STUDY.

10.36106/ijsr/5430960 ◽

2021 ◽

pp. 87-89

Author(s):

Yamen Jabri ◽

Md Mahfooz Buksh ◽

Alicia Skrervin

Keyword(s):

Operative Treatment ◽

Open Surgery ◽

Ct Scanning ◽

Disease Recurrence ◽

Diagnostic Value ◽

Complicated Appendicitis ◽

Risk Patients ◽

Risk Of Disease ◽

One Year

Introduction: Early during the COVID-19 pandemic, the royal college of surgeons advised to use Non-Operative Treatment of appendicitis NOTA or otherwise open surgery for appendicitis. This study has explored the resulted management differences, and the outcome after one year follow up. Methods: Retrospective study covering Pre-pandemic data over March-May,2019 & COVID-19 pandemic data over March-May,2020. We compared the outcome of non-operative treatment approach (NOTA), open and laparoscopic surgical outcome between the 2 groups. Results: The number of admissions was lower in the COVID compared to the Pre-COVID Group (35 vs 43). In the COVID group had more CT scanning of the abdomen and pelvis (65.7% vs 42.2%; p=0.036). There was no difference in the diagnostic value for these imaging methods between the 2 groups (87.5% vs 86.6%) During COVID period Signicantly fewer patients underwent surgery (77.1 vs 92.8; p<0.04), There were signicantly more complicated appendicitis cases in the COVID group compared to Pre-COVID group (59.2 vs 28.2; p:0.021). There was in reduction LOS when comparing Laparoscopic to NOTA (1.7 vs 2.6 days; p:0.03). There has been higher complication rate in the open and NOTA treatments compared to Laparoscopic, but this was not statistically signicant (24.3 % vs 14.8%; p: 0.29). In the NOTA group 41 % of the patients had emergency or interval appendectomy in after one year follow up period. Conclusions: There was a tendency towards conservative approach/open surgery during the pandemic. Our study suggests that Laparoscopic surgery should remain the preferred method of management of appendicitis during COVID-19 pandemic considering the more complicated appendicitis. NOTA should be limited to selected high risk patients. accepting the risk of disease recurrence and need for further interval or emergency surgery

Download Full-text

APPLICATION PROCEDURE EARL Y DIFERENTIAL DIAGNOSIS OF DIFERENT FORMS OF ODONTO - GENIC SEPSIS IN THE KURSK REGIONAL CLINICAL HOSPITAL WITH INTEGRATED SCALES APACHE-2 SOFA SAPS-2 SIRS

The actual problems in dentistry ◽

10.18481/2077-7566-2014-0-6-28-30 ◽

2014 ◽

Vol 10 (6) ◽

pp. 28-30

Author(s):

А. Будаев ◽

A. Budaev ◽

А. Громов ◽

A. Gromov ◽

А. Зыкин ◽

...

Keyword(s):

Differential Diagnosis ◽

Multiple Organ Failure ◽

Organ Failure ◽

Multiple Organ ◽

Predictive Capability ◽

Integral Scales ◽

Medical Academy ◽

Application Procedure ◽

State Medical Academy ◽

Medical University

<p>This work was devoted to improve the efficiency of diagnosis and treatment of patients with odontogenic phlegmons by studying predictive capability of different integral scales. The results of the use of methods for early differential diagnosis of various forms of odontogenic sepsis (development departments Kursk State Medical University and the Voronezh State Medical Academy. NNBurdenko): more than 30 points (the presence of multiple organ failure) – 22 patients (73,3%); less than 30 points (no organ failure) – 8 patients (26,7%). </p>

Download Full-text

Inappropriate manipulation and drainage exacerbate post-operative pain and prolong the hospital stay after laparoscopic appendectomy for pediatric complicated appendicitis

BMC Surgery ◽

10.1186/s12893-021-01413-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yi-Wen Tsai ◽

Shin-Yi Lee ◽

Jyun-Hong Jiang ◽

Jiin-Haur Chuang

Keyword(s):

Hospital Stay ◽

Laparoscopic Appendectomy ◽

Pediatric Patients ◽

Complicated Appendicitis ◽

Postoperative Hospital Stay ◽

Postoperative Outcomes ◽

Chang Gung Memorial Hospital ◽

Abdominal Abscess ◽

Penrose Drain ◽

Drain Group

Abstract Background This study examined whether drain placement or not is associated with the postoperative outcomes of pediatric patients following trans-umbilical single-port laparoscopic appendectomy (TUSPLA) for complicated appendicitis. Methods The medical records of pediatric patients undergoing TUSPLA for acute complicated appendicitis from January 2012 to September 2018 in Kaohsiung Chang Gung Memorial Hospital were reviewed retrospectively. They were classified according to whether they received passive drainage with a Penrose drain (Penrose group) (19), active drainage with a Jackson-Pratt drain with a vacuum bulb (JP group) (16), or no drain (non-drain group) (86). The postoperative outcomes of the three groups were compared. Results Postoperative visual analog scale pain score was significantly higher in the non-drain group than in either the JP group or Penrose group. Patients in the Penrose group had a significantly longer postoperative hospital stay than those in the non-drain group and a higher rate of intra-abdominal abscess, while patients in the JP group had a significantly shorter postoperative hospital stay; moreover, no patient in JP group developed a postoperative intra-abdominal abscess. Conclusions Compared to passive drainage with a Penrose drain or no drain, active drainage with a JP drain shorter the postoperative hospital stay and decreased the risk of postoperative intra-abdominal abscess.

Download Full-text