Complicated appendicitis: Immediate operation or trial of nonoperative management?
Complicated appendicitis
Immediate operation
Nonoperative management
Journal
American journal of surgery
ISSN: 1879-1883
Titre abrégé: Am J Surg
Pays: United States
ID NLM: 0370473
Informations de publication
Date de publication:
04 2019
04 2019
Historique:
received:
07
04
2018
revised:
22
10
2018
accepted:
31
12
2018
pubmed:
13
1
2019
medline:
19
12
2019
entrez:
13
1
2019
Statut:
ppublish
Résumé
The optimal treatment for complicated appendicitis remains controversial. We sought to compare clinical outcomes of patients with complicated appendicitis treated with an immediate operation or a trial of nonoperative management. Adult patients (≥18 years) with complicated appendicitis were included. Patient characteristics and outcomes were compared between the immediate operation group and the nonoperative management group. A total of 101 patients met our inclusion criteria. Of those, 36 patients received an initial trial of nonoperative management with an 86.1% success rate. Patients who failed nonoperative management required significantly longer hospital stays than those in the immediate operation group (11 vs. 5 days). An immediate operation was performed in 65 patients. Open surgery was required in 9 patients (13.8%). Postoperatively, 7 patients (10.8%) required percutaneous drainage of intraabdominal abscess. Nonoperative management was successful in the majority of patients with complicated appendicitis, whereas failure of nonoperative management was associated with prolonged hospital stay. Patients who underwent an immediate operation often required percutaneous drainage of intraabdominal abscess.
Sections du résumé
BACKGROUND
The optimal treatment for complicated appendicitis remains controversial. We sought to compare clinical outcomes of patients with complicated appendicitis treated with an immediate operation or a trial of nonoperative management.
METHODS
Adult patients (≥18 years) with complicated appendicitis were included. Patient characteristics and outcomes were compared between the immediate operation group and the nonoperative management group.
RESULTS
A total of 101 patients met our inclusion criteria. Of those, 36 patients received an initial trial of nonoperative management with an 86.1% success rate. Patients who failed nonoperative management required significantly longer hospital stays than those in the immediate operation group (11 vs. 5 days). An immediate operation was performed in 65 patients. Open surgery was required in 9 patients (13.8%). Postoperatively, 7 patients (10.8%) required percutaneous drainage of intraabdominal abscess.
CONCLUSIONS
Nonoperative management was successful in the majority of patients with complicated appendicitis, whereas failure of nonoperative management was associated with prolonged hospital stay. Patients who underwent an immediate operation often required percutaneous drainage of intraabdominal abscess.
Identifiants
pubmed: 30635209
pii: S0002-9610(18)30465-3
doi: 10.1016/j.amjsurg.2018.12.061
pii:
doi:
Substances chimiques
Anti-Bacterial Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
713-717Informations de copyright
Copyright © 2019 Elsevier Inc. All rights reserved.