A PROSPECTIVE COMPARATIVE STUDY BETWEEN EARLY AND INTERVAL APPENDICECTOMY FOR APPENDICULAR MASS

2021 ◽  
pp. 34-37
Author(s):  
Janni Laxman ◽  
R S Teja Reddy ◽  
Sivasai Krishnaprasad K
Keyword(s):  
Acute Appendicitis ◽  
Comparative Study ◽  
Intestinal Obstruction ◽  
Hospital Stay ◽  
Wound Infection ◽  
Group I ◽  
Interval Appendicectomy ◽  
Simple Mass ◽  
Group Ii ◽  
Appendicular Mass

Acute appendicitis remains the most common cause of acute abdomen requiring surgical intervention. Patients presenting late in acute appendicitis are complicated by the development of an inammatory mass in the right iliac fossa. The treatment of appendicular mass is controversial. However, 1 there are several other management options for appendicular mass. Traditionally, these patients are managed conservatively, followed by interval appendicectomy 4-6 weeks later. Advocates of the initial conservative approach claim a lower rate of complications compared to the early 2 operative approach. Objective: To study the safety and feasibility of emergency appendicectomy for appendicular mass by comparing the complications, morbidity and mortality with conservatively treated patients. Materials & Methods: This is a prospective and comparative study conducted at Gitam Institute of Medical Sciences and Research, Visakhapatnam, from January 2018 to December 2019. A total of 60 patients with appendicular mass were divided into two groups of 30 each. Group I included patients who underwent emergency appendicectomy, while Group II consisted of patients who were managed conservatively. Results:In this study, patients' mean age was 27.58 yrs with a male to female ratio of 2.66:1. Intraoperative ndings in Group I - 20(70%) cases had simple mass, 8(26.66%) had adhesions and loculated pus in 2(6%). In Group II, 14(53.84%) patients had normal ndings, 4(15.38%) cases had simple mass, 6(23%) had adhesions, 1(3.84%) had loculated pus and adhesive intestinal obstruction. Postoperatively, In Group I, 3(10%) patients had wound infection, and 1(3.33%) patient developed fecal stula, which was managed conservatively. In Group II, 2(6.66) patients had wound infection, 4(13.33%) had failure of conservative treatment, four had lost follow-up, 3 had respiratory tract infection, and one patient developed intestinal obstruction due to adhesions. Mean length of hospital stay was 5.3 days in Group I and 8.5 days in Group II. Fewer complications, reduced number of days of parenteral medication, and reduced duration of total hospital stay were noted in Group I compared to Group II, indicating that emergency appendicectomy is a safe and feasible method of managing patients with appendicular mass.

scholarly journals Comparative analysis of early exploration versus conservative approach for management of appendiceal mass

2018 ◽  
Vol 5 (12) ◽  
pp. 3868
Author(s):  
Raj Kumar ◽  
Shivam Madeshiya ◽  
V. K. Pandey ◽  
Ashutosh Shankhdhar
Keyword(s):  
Acute Appendicitis ◽  
Hospital Stay ◽  
Wound Infection ◽  
Clinical Feature ◽  
Interval Appendectomy ◽  
Appendiceal Mass ◽  
Early Return ◽  
Group I ◽  
Early Exploration ◽  
Appendicular Mass

Background: Acute appendicitis is the most common reason for emergency abdominal surgery. Acute appendicitis is ranging from mild inflammation of mucous membrane to gangrene, perforation and peritonitis. Appendicular mass is one of its early complication developing in 2 to 6 % cases of acute appendicitis within 48 hours of attack. Objective of this study was to evaluate the outcome of early surgical exploration and its complications in respect to conservative management followed by interval appendectomy for the management of appendicular mass.Methods: A total 46 cases with clinical feature suggestive of appendicular mass presenting in MLN Medical college, Allahabad were included in study. All cases divided into two equal groups based on mode of management of appendicular mass. Group I (early exploration) and Group II (conservative followed by interval appendectomy).Results: Result will be analysed in terms of hospital stay, morbidity, complications and cost.Conclusions: Early exploration for appendicular mass had advantages of total curative treatment in the index admission, shorter hospital stay, minimal morbidity and ensures early return to work and higher compliance. Operative problems such as localization of appendix, adhesiolysis and bleeding are more pronounced and troublesome with interval appendectomy. Wound infection remains common postoperative complication of early appendectomy in appendicular mass but the rate of wound infection is not so high as to preclude this early operative approach.

scholarly journals The diagnosis of acute appendicitis in pregnant versus non-pregnant women: A comparative study

2016 ◽  
Vol 62 (7) ◽  
pp. 622-627 ◽  
Author(s):  
Abbas Aras ◽  
Erbil Karaman ◽  
Çağhan Pekşen ◽  
Remzi Kızıltan ◽  
Mehmet Çetin Kotan
Keyword(s):  
Retrospective Study ◽  
Acute Appendicitis ◽  
Comparative Study ◽  
Hospital Stay ◽  
Pregnant Women ◽  
Medical Records ◽  
Diagnostic Modality ◽  
Group I ◽  
Group Ii ◽  
Careful Assessment

Summary Objective: To investigate whether the diagnosis of acute appendicitis is affected by pregnancy or not. Method: A retrospective study with the analysis of the medical records of all women suspected of having appendicitis who underwent appendectomy at our hospital between June 2010 and March 2015 were reviewed. The patients were divided into two groups according to whether they were pregnant or not during the surgery: group I, pregnant women, and group II, non-pregnant women. Results: During the study period, 38 pregnant women and 169 non-pregnant women underwent appendectomy. The time from admission to the operation was not statistically different (2.17±1.47 days in group I vs. 1.98±1.66 day in group II; p=0.288). The pregnant group had longer hospital stay than the non-pregnant group (p=0.04). Ultrasonography (USG) was used as the first diagnostic modality in 36/38 patients in group I and 161/169 in group II. The non-visualized appendix on ultrasound was seen in 17 patients in group I and 51 patients in group II, which was not statistically different. Sensitivity and specificity of USG in diagnosis of acute appendicitis were 61.29 and 80.00% in group I, and 93.0 and 31.6% in group II, respectively. Conclusion: Although the diagnosis of appendicitis in pregnant women is not delayed, careful assessment of these patients suspected of having appendicitis should be encouraged when USG examination is normal or nondiagnostic.

scholarly journals APPENDICULAR MASS

2010 ◽  
Vol 17 (02) ◽  
pp. 180-184
Author(s):  
SARDAR ALI ◽  
HAFIZ MUHAMMED RAFIQUE
Keyword(s):  
Conservative Treatment ◽  
Acute Appendicitis ◽  
Cost Effective ◽  
Female Ratio ◽  
Surgical Exploration ◽  
Group I ◽  
Variable Extent ◽  
Group Ii ◽  
Adhesive Intestinal Obstruction ◽  
Appendicular Mass

Introduction: Appendicular mass is a common complication of acute appendicitis. The traditional treatment of this is conservative followed by delayed appendectomy. But now with advancement in all the fields of medicine early surgical exploration of the appendicular mass can be done with satisfactory results. Aims and objectives: A comparison of conservative treatment versus early surgical exploration of appendicular mass. Study Design: Experimental study. Material and Method: Two years study from December 2003 to November 2005 at district headquarters hospital Khanewal. Total 60 patients, both males and females between 12 to 65 years of age with symptoms and signs consistent with appendicular mass were included. They were randomly divided into group I (Early exploration) and group II (Conservative treatment) each containing 30 patients. A comparison of outcome between two groups was done statistically by applying studentChi-square test. Results: There was a peak incidence of acute appendicitis in Second and third decades of life. Male to female ratio was 2:1. More than 90% of patients had history of shifting of abdominal pain. 100% of the patients had inflamed appendix to variable extent on exploration. The complications in the form of adhesive intestinal obstruction; failure of treatment; lost follow up; misdiagnosis and re admissionwere less in group I. There was a significant less duration of hospital stay in group I as compared to Group II. The observations and outcome in this study are almost comparable and correspond with other studies done in this regard. Conclusion: Early surgical exploration of appendicular mass is safe and cost effective.

scholarly journals APPENDICULAR MASS

2010 ◽  
Vol 17 (02) ◽  
pp. 180-184
Author(s):  
SARDAR ALI ◽  
HAFIZ MUHAMMED RAFIQUE
Keyword(s):  
Conservative Treatment ◽  
Acute Appendicitis ◽  
Cost Effective ◽  
Chi Square ◽  
Female Ratio ◽  
Surgical Exploration ◽  
Group I ◽  
Group Ii ◽  
Adhesive Intestinal Obstruction ◽  
Appendicular Mass

Introduction: Appendicular mass is a common complication of acute appendicitis. The traditional treatment of this is conservative followed by delayed appendectomy. But now with advancement in all the fields of medicine early surgical exploration of the appendicular mass can be done with satisfactory results. Aims and objectives: A comparison of conservative treatment versus early surgical exploration of appendicular mass. Study Design: Experimental study. Material and Method: Two years study from December 2003 toNovember 2005 at district headquarters hospital Khanewal. Total 60 patients, both males and females between 12 to 65 years of age with symptoms and signs consistent with appendicular mass were included. They were randomly divided into group I (Early exploration) and group II (Conservative treatment) each containing 30 patients. A comparison of outcome between two groups was done statistically by applying student Chi-square test. Results: There was a peak incidence of acute appendicitis in Second and third decades of life. Male to female ratio was 2:1. More than 90% of patients had history of shifting of abdominal pain. 100% of the patients had inflamed appendix to variable extent on exploration. The complications in the form of adhesive intestinal obstruction; failure of treatment; lost follow up; misdiagnosis and re admissionwere less in group I. There was a significant less duration of hospital stay in group I as compared to Group II. The observations and outcome in this study are almost comparable and correspond with other studies done in this regard. Conclusion: Early surgical exploration of appendicular mass is safe and cost effective.

scholarly journals A retrospective study on patients with appendicular mass after successful conservative treatment and to assess the need for interval appendicectomy

2018 ◽  
Vol 5 (2) ◽  
pp. 513
Author(s):  
Sasikumar M. N. ◽  
Sam Christy Mammen ◽  
Shankar Das
Keyword(s):  
Conservative Treatment ◽  
Acute Appendicitis ◽  
Hospital Stay ◽  
Leucocyte Count ◽  
Length Of Hospital Stay ◽  
Total Leucocyte Count ◽  
Asymptomatic Group ◽  
Asymptomatic Patients ◽  
Interval Appendicectomy ◽  
Appendicular Mass

Background: Appendicular mass is one sequelae in unoperated cases of acute appendicitis which are managed conservatively followed by interval appendicectomy (IA). Currently the need for IA has been questioned due to low risk of recurrence.Methods: Data of all AM patients from 2005 to 2010 were collected and revised the following parameters: age, sex, length of hospital stay, symptoms and signs, total leucocyte count and USG. Those who developed similar pain and those who underwent emergency appendicectomy were considered as recurrence. Patients were grouped as: 1-patients who developed RIF pain,2-asymptomatic patients,3-patients who developed recurrent a/c appendicitis,4-patients who did not developed recurrent a/c appendicitis.Results: Of the 93 patients, 12 patients underwent IA. Average duration between mass resolution and recurrence is 4.16 months. 14.8% patients had recurrent similar abdominal pain, and only 7.4% patients had recurrent acute appendicitis. Length of hospital stay had a statistically significant correlation with recurrence. The mean TC in the group with recurrent acute appendicitis was 12,500 and asymptomatic group who had a mean TC of 10678.28 which was statistically significant.Conclusions: Conservative treatment is successful for majority of appendicular masses. A routine IA seems unnecessary. Asymptomatic patients can be followed up without IA. Most of the recurrences occur within the first 3 to 6 months. Length of hospital stay and total leucocyte count influenced the recurrence. IA may be considered in those who are prone for recurrence.

scholarly journals Randomized comparative study of conventional minilaparoscopy (5mm) versus modern minilaparoscopy (2.9mm) in patients of infertility

2017 ◽  
Vol 6 (4) ◽  
pp. 1539
Author(s):  
Kallol Kumar Roy ◽  
Nandini Joshi nee Jahagirdar ◽  
Murali Subbaiah ◽  
Sunesh Kumar Jain ◽  
J. B. Sharma ◽  
...  
Keyword(s):  
Comparative Study ◽  
Hospital Stay ◽  
Scoring System ◽  
Diagnostic Laparoscopy ◽  
Tertiary Care ◽  
Operating Time ◽  
Group I ◽  
Post Operative Pain ◽  
Significant Difference ◽  
Group Ii

Background: To compare diagnostic conventional minilaparoscopy (5mm) with diagnostic modern minilaparoscopy (2.9mm) in patients of infertility in terms of operating time, post-operative pain, hospital stay.Methods: A prospective randomized comparative study was done in a tertiary care centre involving eighty patients of infertility undergoing diagnostic laparoscopy. Diagnostic laparoscopy was done using 5mm laparoscope (Conventional minilaparoscope-Group I) in 40 patients and using 2.9mm laparoscope (Modern minilaparoscope-Group II) in 40 patients. Operating time was measured from the point of skin incision to closure, post op pain was assessed with VAS scoring system, total hours of hospital stay from shifting to day care recovery ward till discharge was noted.Results: Both conventional minilaroscope and modern minilaparoscopes were comparable to each other. Operating time in both groups was similar (7.7min in Group I vs 8.7min in Group II). In both groups, there was no statistically significant difference in post-operative pain as assessed by VAS scoring System (39 in Group I vs 38 in Group II had mild post-op pain and 1 in Group I vs 2 in Group II had moderate pain). The difference in duration of post-op hospital stay in both Group I and group II was not statistically significant (3.5 hours vs 3.3 hours).Conclusions: Both conventional minilaparoscopy (5mm laparoscope) and modern miniaparoscopy (2.9mm laparoscope) are comparable with respect operating time, post-op pain, hospital stay. Modern minilaparoscope is no better than conventional minilaparoscope.

scholarly journals ACUTE APPENDICITIS: DELAYED SURGERY DOES NOT INCREASE THE NUMBER OF POSTOPERATIVE COMPLICATIONS

2018 ◽  
Vol 28 (2) ◽  
pp. 52-56
Author(s):  
Romualdas Riauka ◽  
Povilas Ignatavičius ◽  
Žygimantas Tverskis ◽  
Žilvinas Dambrauskas
Keyword(s):  
Postoperative Complications ◽  
Acute Appendicitis ◽  
Hospital Stay ◽  
Operating Time ◽  
Length Of Hospital Stay ◽  
Pathology Report ◽  
Perforation Rate ◽  
Group I ◽  
Significant Difference ◽  
Group Ii

Introduction. Historically appendicitis is tending to be operated as soon as possible to prevent future complications. Recent discussions show, that urgent operation does not always reduce the rate of postoperative complications. Immediate appendectomy can be delayed in some cases. Methods. Retrospective, non-randomized, single center, cohort study was performed. During one-year period 167 consecutive patients diagnosed with acute appendicitis were included in the study. The study population was divided into two groups according to the time from the onset of the symptoms to the operation. Group I (≤ 24 hours) - 74 patients and Group II (≥ 24 hours) – 93 patients. Primary (postoperative complications) and secondary (operating time, length of hospital stay and perforation rate at the final pathology report) endpoints were evaluated and compared. Results. There was no statistically significant difference in the rate of postoperative complications when comparing both groups. In Group I – 21.9% patients (87.5% Grade I) and in Group II – 25.8% patients (83% Grade I) had postoperative complications. Operating time was similar between the groups (72.97±29.1 (Group I) vs 79.95±35.4 minutes (Group II)). Length of hospital stay was longer in Group II, but no statistically significant difference was found (2.85±2.3 vs 3.34±4.88 days accordingly). Perforation rate at the final pathology report was twice higher in Group II (8 (10.8%) vs 17 (18.3%)), but no statistically significant difference was found. Conclusions. This study findings support earlier reports showing that delayed appendectomy is safe surgical procedure without higher rate of postoperative complications and may be applied in certain cases.

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 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 A COMPARATIVE STUDY BETWEEN EARLY EXPLORATIONS VERSUS CONSERVATIVE MANAGEMENT IN MANAGEMENT OF APPENDICULAR LUMP

2021 ◽  
Vol 5 (10) ◽  
Author(s):  
Sanjay Patidar ◽  
Kritika Kamal ◽  
Jaydip Sinh Kathota ◽  
Sudhanshu Tiwari ◽  
Prashant Nakrani
Keyword(s):  
Acute Appendicitis ◽  
Intestinal Obstruction ◽  
Conservative Management ◽  
Research Centre ◽  
Age Group ◽  
Surgical Exploration ◽  
Hospitalization Time ◽  
Group I ◽  
Group Ii ◽  
Adhesive Intestinal Obstruction

Background: Acute Appendicitis is one of the most common acute surgical conditions of the abdomen and appendicular lump is formed if treatment is delayed. Appendicular mass is one of its early complications developing in   2-6% cases within48 hours of attack. The traditional treatment of appendicular lump is conservative followed by delayed appendectomy. During conservative treatment 10-20% is not resolved and leads to gangrene or perforation followed by localized abscess or generalized peritonitis requiring early surgical intervention. Aim and Objective: To evaluate the outcome of early surgical exploration and its complications in respect to conservative management of appendicular lump. Material and Methods: Total of 48 patients admitted with diagnosis of appendicular lump were included in our study. This prospective study was conducted in Department of General Surgery of Index Medical College, Hospital and Research Centre, Indore, M.P over period of 2 years [August 2019 to July 2021] in all age group and both sexes. All cases were divided randomly into two groups. Group I, early surgical exploration and Group II, conservative approach with OCHSNER SHERREN REGIME followed by interval appendectomy after 6 weeks. Results: Total 471 patients admitted to hospital with diagnosis of acute appendicitis, out of which total 48 patients were having Appendicular lump suggestive of incidence of 9.81%. Maximum patients were found in age group 21-30 years. Average duration of symptoms was 2 days. Two methods were adopted for the management of appendicular lump. The first group included 24 patients who were operated immediately after investigations and second group of 24 patients were managed conservatively followed by delayed appendectomy. In the first group mean hospitalization time was 4 days. Residual abscess, adhesive intestinal obstruction, failure of treatment and readmission were not found. In the group II, mean hospitalization time 10 days, more chances of residual abscess, adhesive intestinal obstruction, failure of treatment and readmissions were noted. Conclusion: In our study, it can be concluded that early surgical exploration confirms diagnosis and cures the problem, reduce the cost of management, shortens the convalescence and hospital stay with reasonably satisfactory outcome. Key-Words: Appendicular Lump, Ochsner-Sherren Regime Appendectomy.

Sign in / Sign up

Export Citation Format

Share Document