scholarly journals Tactical approaches to the surgical treatment of patients with complicated forms of acute appendicitis and abdominal sepsis with a high risk of cardiopulmonary insufficiency

2019 ◽  
Vol 41 part 2 (2) ◽  
pp. 44-48
Author(s):  
B. S. Zaporozhchenko ◽  
Khasan Yakhia ◽  
I. E. Borodaev ◽  
V. N. Kachanov ◽  
A. A. Vasiliev
Keyword(s):  
High Risk ◽  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Standard Procedure ◽  
Abdominal Cavity ◽  
Open Appendectomy ◽  
Abdominal Sepsis ◽  
Group I ◽  
Almost All ◽  
Complicated Acute Appendicitis

Purpose of the study. To determine the feasibility and effectiveness of the laparoscopic method of treatment of patients with complicated forms of acute appendicitis. in patients with high risk of cardiopulmonary failure and to determine the indications for the use of various methods of laparoscopic appendectomy. Materials and methods. The result of treatment of 67 patients with acute appendage with high risky cardiopulmonary insufficiency. Of these, 10 patients (14,9%) were diagnosed with sepsis. The patients were divided into two groups: Group I: 29 (43,3%) patients with complicated acute appendicitis, with a high risk of cardiopulmonary insufficiency, who underwent open appendectomy. Open appendectomy was performed according to the standard procedure from the Volkovich-Dyakonov (Mac-Burney) incision in 19 (65,5%) patients, in 10 (34,5%) median laparotomy. Group II: 38 (56,7%) patients with complicated acute appendicitis who underwent laparoscopic appendectomy, and drainage of the abdominal cavity. Classical laparoscopic surgery with the imposition of pneumoperitoneum was performed in 20 (29,8%) patients and using the laparolifting method in 18 (26,9%) patients Results. 38 (56,7%) patients were operated on using laparoscopic techniques. During laparoscopic interventions, intraoperative revision and appendectomy were performed. This technique is absolutely safe, reliable and affordable in the performance of most surgeons. Conclusions. Laparoscopic appendectomy with complicated forms of acute appendicitis can be performed in almost all patients with acute appendicitis with a high risk of cardiopulmonary insufficiency. Keywords: acute appendicitis, complicated appendicitis, appendectomy, cardiopulmonary insufficiency, laparoscopy. sepsis.

scholarly journals The peculiarity of appendectomy of patients with high risk of cardiopulmonary insufficiency

2018 ◽  
Vol 22 (3) ◽  
pp. 456-459
Author(s):  
B.S. Zaporozhchenko ◽  
Hasan Yahya ◽  
I.I. Borodaev ◽  
V.N. Kachanov ◽  
O.A. Vasyliev
Keyword(s):  
High Risk ◽  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Abdominal Cavity ◽  
Open Appendectomy ◽  
Pulmonary Insufficiency ◽  
Results Of Treatment ◽  
Cardiopulmonary Failure ◽  
Group 2 ◽  
Group 1

Acute appendicitis (AA) ranks first in the frequency of emergence of urgent surgical diseases in hospitals in Ukraine. In recent years, laparoscopic appendectomy has become one of the “gold standards” of surgery. Of particular interest in this group of patients is a gasless and with small amount of gas laparoscopy, in which the endosurgical space in the abdominal cavity is created with the help of endolifts, in which the abdominal wall is raised mechanically, without creating a pneumoperitoneum. Objective — to determine the feasibility and effectiveness of the use of various techniques for laparoscopic appendectomy of patients with a high risk of cardiopulmonary insufficiency. All patients with АA were divided into 2 groups: Group 1 — 72 patients with АA diagnosis, with a high risk of cardiopulmonary failure, who underwent open appendectomy; Group 2 — 85 patients with АA diagnosis with a high risk of cardiopulmonary failure, who underwent laparoscopic appendectomy with pneumoperitoneum and using laparolifting method of patients. The laparolifting was performed with the help of the device developed by the clinic for laparolifting on Zaporozhchenko-Kolodii. When analyzing the results of treatment of patients with IІ group, it should be noted that laparoscopic appendectomy, especially with laparolifting, may be the operation of choice in the treatment of patients with acute appendicitis. This technique is absolutely safe, reliable and affordable in the implementation of most surgeons. So, laparoscopic appendectomy can be performed in virtually all patients with acute appendicitis with high risk of cardio-pulmonary insufficiency with the avoidance of postoperative complications.

scholarly journals CHOOSING A METHOD OF SURGICAL TREATMENT OF ACUTE APPENDICITIS IN PATIENTS WITH CONCOMITANT PULMONARY PATHOLOGY

2020 ◽  
pp. 165-168
Author(s):  
Y. Hasan ◽  
I. E. Borodayev ◽  
V. V. Kolodiy ◽  
V. N. Kachanov ◽  
V. B. Volkov
Keyword(s):  
Surgical Treatment ◽  
High Risk ◽  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Open Appendectomy ◽  
Optimal Method ◽  
Cardiopulmonary Disease ◽  
Abdominal Organs ◽  
Group I ◽  
Pulmonary Pathology

Summary. The article analyzes the experience of using endovideosurgical method of treatment of patients with АA with pulmonary pathology, determines the indications for the use of different methods of applying pneumoperitoneum when performing laparoscopic appendectomy (LA). Material and method. The result of treatment of 46 patients with acute appendicitis (АA) and concomitant pulmonary pathology in the last 5 years is given. Group I included 14 patients diagnosed with AA with concomitant pulmonary pathology who underwent open appendectomy, and II — 32 patients with a diagnosis of AA with concomitant pulmonary pathology, who underwent laparoscopic appendectomy with the imposition of pneumoperitoneum and metaphormia. Result. The evaluation of the treatment of 32 patients (84.8 %) with concomitant pulmonary pathology performed by LA, which allowed to dramatically reduce the number of complications from the abdominal organs, as well as to reduce the frequency of decompensation of concomitant pulmonary pathologies. Conclusions. Performing a laparolifting laparoscopic appendectomy is the optimal method for patients at high risk for cardiopulmonary disease.

scholarly journals Post-surgical outcomes of laparoscopic appendectomy observed at BIRDEM hospital

2017 ◽  
Vol 11 (1) ◽  
pp. 15-18 ◽  
Author(s):  
Tapash Kumar Maitra ◽  
Mahmud Ekramullah ◽  
Faruquzzaman ◽  
Samiran Kumar Mondol
Keyword(s):  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Abdominal Cavity ◽  
Open Appendectomy ◽  
Laparoscopic Approach ◽  
Clinical History ◽  
Laparoscopic Technique ◽  
Operative Outcomes ◽  
The Mean ◽  
Almost All

Background and Objective: Currently, laparoscopic appendectomy (LA) is widely practiced for the management of acute appendicitis (AA). The application of laparoscopic technique for appendectomy is expanding very rapidly and now performed in almost all major cities and tertiary level hospitals. This study addressed to determine the outcomes of laparoscopic appendectomy in our surgical setup at Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorder (BIRDEM).Methodology: All admitted patients at BIRDEM hospital and clinically diagnosed as acute appendicitis considered eligible for the study. Based on clinical history relevant and routine biochemical investigations were done. A board of experienced surgeons selected the eligible cases for LA. The study continued from Sept 2014 to Sept 2016.Result: A total of 47 (M / F = 21 / 26) patients with acute appendicitis were admitted during this period. The mean (SD) age was 21 (±1.4) years in male and 19 (±1.7) years in female. The mean age of the total patients was 20 (±1.6) years. Eighty percent of the patients were of age 30 years or less. Per-operative laparoscopic findings revealed that five cases (10.6%) were misdiagnosed as appendicitis. Two (4.2%) cases were found to have other pathology and necessitated open appendectomy (OA). One was suspected for malignancy and other had appendicitis with adhesion. Overall, four important post-operative outcomes were observed: (a) post-operative pain was found reducing gradually and it fell below pain score 2 or even less after 30 hours; (b) port-site bleeding and infection were observed in 4.3% and 2.1%, respectively; (c) none had visceral bleeding or subcutaneous emphysema and (d) more than 80% were discharged within 72 hours.Conclusion: Most of the patients admitted with acute appendicitis were of younger age (<30 years). Though there was no comparative group undergoing open appendectomy (OA), it was apparent that laparoscopic approach was proved to have reduced pain, less complication and shorter hospital stay thus reducing the treatment cost. Thus, LA was found relatively safe and resilient procedure. An additional benefit of laparoscopy was that it revealed about 10% case were misdiagnosed as having appendicitis. Thus, this approach may be considered as a step forward in the treatment of appendicitis making easier to explore the abdominal cavity while keeping an option to perform an OA.IMC J Med Sci 2017; 11(1): 15-18

Compare the Outcomes of Laparoscopic and Open Appendectomy

2021 ◽  
Vol 15 (7) ◽  
pp. 1742-1744
Author(s):  
Aqeel Ahmad ◽  
Muhammad Hammad Muzaffar ◽  
Mumtaz Ahmad Khan ◽  
Arshid Mahmood
Keyword(s):  
Acute Appendicitis ◽  
Surgical Site Infection ◽  
Hospital Stay ◽  
Laparoscopic Appendectomy ◽  
Open Appendectomy ◽  
Site Infection ◽  
Time Duration ◽  
Group I ◽  
Significant Difference ◽  
Group Ii

Aim: The aim of this study is to compare the surgical site infection, hospital stay and time duration of procedure in patients undergoing laparoscopic and open appendectomy. Study Design: Prospective/ Observational Place & Duration: Department of Surgery, Pak Red Crescent Medical and Dental college, Dina Nath, during from Jan 2020 to March 2021. Methods: In this study 240 patients of both genders with ages >10 years presented with acute appendicitis were included. Patients demographic including age, sex and body mass index were recorded after written consent. Patients were equally divided into two groups. Group I consist of 120 patients and received laparoscopic appendectomy and Group II with 120 patients received open appendectomy. Outcomes such as surgical site infection, hospital stay and time duration of procedure were examined and compare the results between both groups. Data was analyzed by SPSS 23.0. P-value <0.05 was set as significant. Results: There were 140 (58.3%) patients (70 Group I, 70 Group II) were male with mean age 25.7+6.54 years while 100 (41.7%) patients (50 Group I, 50 Group II) were females with mean age 26.9+3.12 years. No significant difference regarding BMI between both groups p=>0.05. There was a significant difference in term of surgery time duration between both groups 48.24+9.59 minutes Vs 35.74+6.86 minutes; P=0.001. No significant difference observed in term of hospital stay (p=0.345). 11 (9.2%) patients in Group II in which 5.83% had Superficial SSI and 3.7% had Deep SSI. 9 (7.5%) patients 5% superficial and 2.5% Deep SSI in Group I had developed surgical site infection with no significant difference (p=0.41). Conclusion: We concluded in this study that open appendectomy is better in term of operative time as compared to laparoscopic appendectomy. We found no significant difference regarding surgical site infection and hospital stay. Keywords: Acute appendicitis, Appendectomy, Laparoscopic, Open, Outcomes

scholarly journals Comparative study and outcome of open versus laparoscopic appendectomy: case series of 60 patients

2017 ◽  
Vol 4 (9) ◽  
pp. 3129
Author(s):  
Neeraj Sharma ◽  
Mayank Mishra ◽  
Alok Tripathi ◽  
Vivekanand Rai
Keyword(s):  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Open Appendectomy ◽  
Case Series ◽  
P Value ◽  
Chi Square ◽  
Early Return ◽  
Group I ◽  
Duration Of Surgery ◽  
Open Versus

Background: Laparoscopic appendectomy combines the advantages of diagnosis and treatment in one procedure with least morbidity. Patients are likely to have less postoperative pain and to be discharged from hospital and return to activities of daily living sooner than those who have undergone open appendectomy.Methods: This prospective study was carried out in the Department of Surgery, Heritage IMS, Varanasi, from May 2016 to May 2017. All the patients were randomly divided into two groups, Group I (Lap App) and Group II (Open App). All quantitative data was compared by independent sample test. All qualitative data was compared by chi-square test. A p-value <0.05 was considered statistically significant.Results: In present study 19 (63%) patients of open appendectomy and 19 (63%) patients of laparoscopic appendectomy were males. 11 (36%) patients of open appendectomy and 11 (36%) laparoscopic appendectomy were females.Conclusions: This study from May 2016 to April 2017 was done on 60 (30 lap and 30 open) patients with clinical diagnosis of acute appendicitis admitted in surgical wards of Heritage Institute of Medical Sciences. In spite of drawback of the increase in duration of surgery, we conclude that laparoscopic appendectomy is better than the open method for acute appendicitis, with less post-operative pain and reduced duration of analgesics used, with lesser incidences of post-operative complications, shorter duration of hospital stays, early return to normal work.

scholarly journals Compare Laparoscopic and Open Appendectomy in Terms of Surgical Site Infection

2021 ◽  
Vol 15 (8) ◽  
pp. 2375-2377
Author(s):  
Muhammad Yousaf ◽  
Shahid Khan Afridi ◽  
Gul Sharif ◽  
Wasim Ahmad ◽  
Shoaib Muhammad ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Surgical Site Infection ◽  
Hospital Stay ◽  
Laparoscopic Appendectomy ◽  
Open Appendectomy ◽  
Site Infection ◽  
Time Duration ◽  
Group I ◽  
Significant Difference ◽  
Group Ii

Aim: The aim of this study is to compare the outcomes between laparoscopic and open appendectomy in terms of surgical site infection. Study Design: Prospective/ Observational Place & Duration: Department of Surgery, Lady Reading Hospital, Peshawar for duration of six months from January 2021 to June 2021. Methods: In this study 200 patients of both genders with ages >10 years presented with acute appendicitis were included. Patients’ demographics including age, sex and body mass index were recorded after written consent. Patients were equally divided into two groups. Group I consist of 100 patients and received laparoscopic appendectomy and Group II with 100 patients received open appendectomy. Outcomes such as surgical site infection, hospital stay and time duration of procedure were examined and compare the results between both groups. Data was analyzed by SPSS 26.0. P-value <0.05 was set as significant. Results: There were 120 (60%) patients (60 Group I, 60 Group II) were males while 80 (40%) patients (40 Group I, 40 Group II) were females. Mean age in group I was 27.9+4.45 years and in group II mean age was 28.5+4.21 years. Mean BMI in group I was 24.08+8.22 kg/m2 and in group II mean BMI was 25.03+6.17 kg/m2. There was a significant difference in term of surgery time duration between both groups 42.88+13.75 minutes Vs 33.35+9.55 minutes; P=0.003.Hospital stay was greater in group II 6.03+3.12 days as compared to group I 4.07+6.13 days. Post operatively less SSI was found among laparoscopic group 6 (6%) in which 4% had superficial SSI and 2% had deep SSI as compared to group II 12 (12%) SSI was found among in which 8% had superficial SSI and 4% had deep SSI. Conclusion: We concluded in this study that laparoscopic appendectomy is better in terms of less hospital stay with less surgical site infection as compared to open appendectomy. We found that less operative time was observed in open appendectomy as compared to laparoscopic. Keywords: Appendectomy, Outcomes, Laparoscopic, Open, Acute appendicitis

scholarly journals Unligature method of laparoscopic appendectomy in children

2020 ◽  
Vol 10 (1) ◽  
pp. 53-58
Author(s):  
Vyacheslav G. Svarich ◽  
Evgeniy G. Perevozchikov ◽  
Ilya M. Kagantsov
Keyword(s):  
Postoperative Complications ◽  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Open Appendectomy ◽  
Operation Time ◽  
High Energy ◽  
Inflammatory Infiltration ◽  
Surgical Department ◽  
Clinical Hospital ◽  
Digital Assessment

Aim. On the basis of the accumulated clinical material to show the possibility of a ligature-free method of laparoscopic appendectomy in children. Materials and methods. From 2000 to 2019, 2044 children with acute appendicitis were treated in the surgical department of the Republican childrens clinical hospital in Syktyvkar. Of these, 651 patients had an open appendectomy with treatment of the stump of the vermiform process by the submersible method, 1363 children had a laparoscopic appendectomy with ligature treatment of the stump of the process, and 32 patients had their first non-ligature laparoscopic appendectomy with the intersection of the vermiform process with the Ligasure device. Results. On average, surgery for ligature-free laparoscopic appendectomy lasted 7 3 minutes less than for laparoscopic appendectomy using the ligature method for treating the stump of the worm-like process. Experimentally, it was found that this method of appendectomy should not be used when the thickness of the worm-like process is more than 1.5 cm, with pronounced inflammatory infiltration of the caecum dome and perforation at the base of the process. With ligature-free appendectomy, the operation time was reduced. In the period from 1 to 6 months, there were no intra-abdominal postoperative complications associated with the new method of surgery. Conclusion. Ligar-free laparoscopic appendectomy in children using modern high-energy platforms with a digital assessment of the degree of tissue coagulation readiness made it possible to avoid intraoperative and postoperative complications, simplify the technique of its implementation, and reduce the time of surgery.

scholarly journals Mathematical modeling for prediction of complicated acute appendicitis in children

2018 ◽  
Vol 1 (1) ◽  
pp. 70-80
Author(s):  
V. S. Konoplitsky ◽  
V. V. Motygin ◽  
A. G. Yakimenko ◽  
D. V. Dmytriiev ◽  
T. I. Mikhalchuk
Keyword(s):  
Mathematical Model ◽  
Acute Appendicitis ◽  
Postoperative Period ◽  
Abdominal Cavity ◽  
Control Group ◽  
Toxic Substances ◽  
Healthy Children ◽  
Endogenous Intoxication ◽  
Complicated Course ◽  
Complicated Acute Appendicitis

Endogenous intoxication, which accompanies the complicated course of acute appendicitis in children, is one of the serious conditions, which are the main cause of complications in the postoperative period. Diverse clinical observations done by clinicians suggest that despite the use of modern technologies in operating equipment, anesthetic support, the number of complications in the postoperative period has no tendency to decrease, and the main cause of lethal outcomes with appendicular peritonitis is lightning development of severe degree of endotoxicosis, which develops as a result of resorbing toxic substances formed of many components, including pathogenic microflora and destruction metabolism. Purpose. Creation of a mathematical model for prediction of complicated acute appendicitis in children using the functions of regression analysis of EXCEL spreadsheet by approximating experimental data. Materials and methods. In the work, there is information about 59 patients with acute appendicitis treated at the clinic of pediatric surgery at the National Pirogov Memorial Medical University. The data on patients were divided into two groups: patients with not complicated course of pathology – 24 patients, and patients with complicated course of acute appendicitis – 35 children. The control group served the data of 37 healthy children. In each of the three groups, the following parameters were studied: gender, age, bed day, duration of the disease, presence of symptoms of peritoneal irritation, the nature of exudate in the abdominal cavity, the number of red blood cells, hemoglobin, leukocytosis, quantitative characteristics of white blood formula, ESR, cellogenic endogenous intoxication: leukocyte index of intoxication and hematological index of intoxication. All the data were determined directly at the time of hospitalization of a patient to the hospital. Results. Discussion. Based on multiple correlation x = f (x1 , x2 ) a two-factor mathematical model of probability of the complicated course of acute appendicitis in children was created. According to the obtained results of the study of the system of three equations with three unknowns, it was established that if the indicator of the form of the disease is y = 2.67 and above, when, in numerical terms, the result falls into the zone of complicated flow of acute appendicitis and completely coincides with data analysis of the three groups of patients. Conclusions. The components that determine the uncomplicated course of acute appendicitis in children, according to the developed two-factor model, include LII and GPI, which exceed the values intoxication of certain intervals studied at the time of hospitalization. The analyzed indices were determined by the degree of severity of the pathological process, duration of disease, virulence of microflora and age of patients against the background of the formed endogenous intoxication syndrome.

scholarly journals Laparoscopic Appendectomy Trends and Outcomes in the United States: Data from the Nationwide Inpatient Sample (NIS), 2004–2011

2014 ◽  
Vol 80 (10) ◽  
pp. 1074-1077 ◽  
Author(s):  
Hossein Masoomi ◽  
Ninh T. Nguyen ◽  
Matthew O. Dolich ◽  
Steven Mills ◽  
Joseph C. Carmichael ◽  
...  
Keyword(s):  
United States ◽  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Conversion Rate ◽  
Nationwide Inpatient Sample ◽  
Open Appendectomy ◽  
Perforated Appendicitis ◽  
The United States ◽  
Hospital Charges ◽  
Nationwide Inpatient Sample Database

Laparoscopic appendectomy (LA) is becoming the standard procedure of choice for appendicitis. We aimed to evaluate the frequency and trends of LA for acute appendicitis in the United States and to compare outcomes of LA with open appendectomy (OA). Using the Nationwide Inpatient Sample database, we examined patients who underwent appendectomy for acute appendicitis from 2004 to 2011. A total of 2,593,786 patients underwent appendectomy during this period. Overall, the rate of LA was 60.5 per cent (children: 58.1%; adults: 63%; elderly: 48.7%). LA rate significantly increased from 43.3 per cent in 2004 to 75 per cent in 2011. LA use increased 66 per cent in nonperforated appendicitis versus 100 per cent increase in LA use for perforated appendicitis. The LA rate increased in all age groups. The increased LA use was more significant in male patients (84%) compared with female patients (62%). The overall conversion rate of LA to OA was 6.3 per cent. Compared with OA, LA had a significantly lower complication rate, a lower mortality rate, a shorter mean hospital stay, and lower mean total hospital charges in both nonperforated and perforated appendices. LA has become an established procedure for appendectomy in nonperforated and perforated appendicitis in all rates exceeding OA. Conversion rate is relatively low (6.3%).

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