Preoperative appendix diameter obtained by computerized tomography scanning predicts conversion from laparoscopic to open appendectomy.
Adult
Appendectomy
/ adverse effects
Appendicitis
/ diagnostic imaging
Appendix
/ anatomy & histology
C-Reactive Protein
/ analysis
Female
Humans
Inflammation
/ blood
Laparoscopy
/ adverse effects
Male
Middle Aged
Preoperative Care
Retrospective Studies
Tomography, X-Ray Computed
/ methods
Treatment Outcome
Turkey
/ epidemiology
Appendectomy
conversion
predictivity
Journal
Nigerian journal of clinical practice
ISSN: 1119-3077
Titre abrégé: Niger J Clin Pract
Pays: India
ID NLM: 101150032
Informations de publication
Date de publication:
Jul 2020
Jul 2020
Historique:
entrez:
5
7
2020
pubmed:
6
7
2020
medline:
27
10
2020
Statut:
ppublish
Résumé
Open appendectomy (OA) has been the gold standard for a long time. Laparoscopic appendectomy (LA) has gained wide acceptance and popularity, outdoing open approach. Yet, conversion may be required when laparoscopic approach fails. To predict conversion from laparoscopic appendectomy to open appendectomy sing Oreo-ratio radiological appendices diameter. This is a retrospective cohort study conducted on 320 (included) patients who underwent appendectomy between January 2018 and August 2018 in the General Surgery departmentof Haseki Training and Research Hospital, Istanbul, Turkey. Appendiceal diameter obtained during preoperative radiological screening was evaluated about its relationship to conversion from LA to OA. Age, sex, inflammatory serum parameters and pathology reports were also investigated. A total of 269 (84%) cases were started LA and 17 (6,3%) laparoscopic cases were converted to open. The appendix diameter, the grade of inflammation (perforated or gangrenous), age, and c-reactive protein (CRP) were found to have significant importance in conversion, P = 0.003, P = 0.000, P = 0.042, and P = 0.018, respectively. When a cutoff of 50 years was chosen for age, the odds ratio (OR) was 3. For the appendiceal diameter of 14 mm, the OR was 3.0286. Preoperative evaluation of appendix diameter is a quick and useful method for a surgeon to distinguish cases with risk of conversion in the emergency department. The other risk factors associated with conversion of LA to OA are grade of inflammation, age and CRP levels.
Sections du résumé
BACKGROUND
BACKGROUND
Open appendectomy (OA) has been the gold standard for a long time. Laparoscopic appendectomy (LA) has gained wide acceptance and popularity, outdoing open approach. Yet, conversion may be required when laparoscopic approach fails.
AIMS
OBJECTIVE
To predict conversion from laparoscopic appendectomy to open appendectomy sing Oreo-ratio radiological appendices diameter.
MATERIALS AND METHODS
METHODS
This is a retrospective cohort study conducted on 320 (included) patients who underwent appendectomy between January 2018 and August 2018 in the General Surgery departmentof Haseki Training and Research Hospital, Istanbul, Turkey. Appendiceal diameter obtained during preoperative radiological screening was evaluated about its relationship to conversion from LA to OA. Age, sex, inflammatory serum parameters and pathology reports were also investigated.
RESULTS
RESULTS
A total of 269 (84%) cases were started LA and 17 (6,3%) laparoscopic cases were converted to open. The appendix diameter, the grade of inflammation (perforated or gangrenous), age, and c-reactive protein (CRP) were found to have significant importance in conversion, P = 0.003, P = 0.000, P = 0.042, and P = 0.018, respectively. When a cutoff of 50 years was chosen for age, the odds ratio (OR) was 3. For the appendiceal diameter of 14 mm, the OR was 3.0286.
CONCLUSION
CONCLUSIONS
Preoperative evaluation of appendix diameter is a quick and useful method for a surgeon to distinguish cases with risk of conversion in the emergency department. The other risk factors associated with conversion of LA to OA are grade of inflammation, age and CRP levels.
Identifiants
pubmed: 32620728
pii: NigerJClinPract_2020_23_7_975_288875
doi: 10.4103/njcp.njcp_360_19
doi:
Substances chimiques
C-Reactive Protein
9007-41-4
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
975-979Déclaration de conflit d'intérêts
None