Akademik Veri Yönetim Sistemi
Laparoscopic Endoscopic Surgical Science, sa.3, ss.1-7, 2018 (Hakemli Dergi)
Retrospective analysis of clinical and surgical results of 123 patients prediagnosed with acute appendicitis
Necip Altundaş, Umut Orkun Çelebi
Department of General Surgery, T.C. Ministry of Health Erzurum Oltu State Hospital, Erzurum, Turkey
ABSTRACT
Introduction: Acute appendicitis is a disease requiring urgent surgical intervention. It is frequently encoun- tered in general surgical clinics. Maintaining a good medical record and physical examination are the first priorities in diagnosing appendicitis. This study aimed to evaluate the clinical and surgical results of pa- tients prediagnosed with acute appendicitis in a Erzurum Oltu State Hospital.
Materials and Methods: The records of the 123 patients [49 (39.8%) female and 74 (60.2%) male], who were diagnosed with acute appendicitis in the hospital between 2015 and 2017, were retrospectively analyzed in terms of age, gender, Alvarado score, and laboratory and radiology findings. Furthermore, surgical methods were examined with regard to the duration of surgery, hospitalization, and complications.
Results: A total of 32 (26%) patients were scanned with ultrasonography (US), 91 (74%) with computed tomography (CT), and 12 (9.7%) with both US and CT. Laparoscopic appendectomy (LA) was performed in 66 (53.6%) patients, and open appendectomy (OA) in 57 patients (46.4%). Further, 71 (57.8%) of the 120 patients with intraoperatively diagnosed appendicitis had suppurative, 38 (30.9%) had catarrhal, 8 (6.5%) had perforated, 3 (2.4%) had gangrenous appendicitis. The histopathological and intraoperatively diagnosis of the remaining 3 (2.4%) patients was normal. Three (2.4%) of the patients who underwent OA developed ileus, and one (0.8%) patient had wound infections. One (0.8%) patient who underwent LA developed ileus.
Conclusion: The effective use of laboratory, scoring, and assisted imaging methods can reduce the rates of negative appendectomy and postoperative complications. Laparoscopic surgery has a positive effect on postoperative pain and quality of life. If laparoscopic equipment and experience with the method are suffi- cient, the first choice should be laparoscopic surgery for acute appendicitis.
Keywords: Acute appendicitis; histopathological diagnosis; laparoscopic appendectomy; open appendectomy.
Original Article
Introduction
Acute appendicitis is one of the diseases requiring ur- gent surgical intervention. It is frequently encountered in general surgical clinics.[1] Maintaining a good medical record and physical examination are the first priorities in diagnosing appendicitis, despite medical innovations
and increased experience.[2] The number of unnecessary surgeries and related complications can be reduced using auxiliary methods such as scoring systems (Alvarado), ultrasonography (US), computed tomography (CT), mag- netic resonance imaging, and laparoscopy in diagnosing appendicitis.[3]
Received: 20.08.2018 Accepted: 03.09.2018
Correspondence: Necip Altundaş, M.D., Department of General Surgery, T.C. Ministry of Health Erzurum Oltu State Hospital, Erzurum, Turkey
e-mail: altunnecip@gmail.com