Application value of high-frequency ultrasonography in endoscopic retrograde appendicitis therapy for pediatric acute appendicitis.
Endoscopic retrograde intra-appendiceal irrigation
High-frequency ultrasonography
Pediatric acute appendicitis
Journal
Surgical endoscopy
ISSN: 1432-2218
Titre abrégé: Surg Endosc
Pays: Germany
ID NLM: 8806653
Informations de publication
Date de publication:
05 2023
05 2023
Historique:
received:
11
05
2022
accepted:
27
11
2022
medline:
5
5
2023
pubmed:
24
1
2023
entrez:
23
1
2023
Statut:
ppublish
Résumé
Endoscopic retrograde appendicitis therapy (ERAT) is a new method of treating acute appendicitis that has emerged in recent years in children, but the application of radiological examination in the diagnosis and treatment of pediatric diseases is greatly limited. Therefore, high-frequency ultrasonography imaging has attracted more and more attention because of its advantages such as non-invasiveness, no radiation, and a simpler procedure. This study aims to explore the application value of high-frequency ultrasonography in ERAT for pediatric acute appendicitis. A retrospective analysis was conducted on 136 children admitted to our hospital from January 2020 to October 2021 who were definitively diagnosed with acute appendicitis and underwent endoscopic retrograde intra-appendiceal irrigation treatment under the guidance of high-frequency ultrasonography. They were divided into the preschool age group (< 6 years) and school age group (≥ 6 years) according to age. Before the operation and at 1-2 days after ERAT, the external diameter of the appendix, as well as the thickness of the intestinal wall, mucosal layer, and muscular layer in each group were measured by high-frequency ultrasonography and recorded in detail. During the operation, a stent was placed under real-time guidance, and the situation in the cavity was observed. The clinical data of the two groups of children before and after the operation were collected, and the recurrence status after treatment was followed up. Endoscopic treatment was completed in 131 patients with a success rate of 96.32%. There was no significant difference between the two groups in appendix diameter, intestinal wall, or muscular layer after the operation when compared to those before the operation (p > 0.05), but there was a significant difference in the mucosal thickness after operation when compared to before the operation (p < 0.05). Abdominal pain in the two groups was significantly relieved immediately after the operation, and the white blood cell count returned to normal, with a significant difference before and after the ERAT operation (p < 0.05). Endoscopic intra-appendiceal irrigation under the guidance of high-frequency ultrasonography is a real-time and convenient method that is safe and effective in treating pediatric acute appendicitis.
Sections du résumé
BACKGROUND
Endoscopic retrograde appendicitis therapy (ERAT) is a new method of treating acute appendicitis that has emerged in recent years in children, but the application of radiological examination in the diagnosis and treatment of pediatric diseases is greatly limited. Therefore, high-frequency ultrasonography imaging has attracted more and more attention because of its advantages such as non-invasiveness, no radiation, and a simpler procedure. This study aims to explore the application value of high-frequency ultrasonography in ERAT for pediatric acute appendicitis.
METHODS
A retrospective analysis was conducted on 136 children admitted to our hospital from January 2020 to October 2021 who were definitively diagnosed with acute appendicitis and underwent endoscopic retrograde intra-appendiceal irrigation treatment under the guidance of high-frequency ultrasonography. They were divided into the preschool age group (< 6 years) and school age group (≥ 6 years) according to age. Before the operation and at 1-2 days after ERAT, the external diameter of the appendix, as well as the thickness of the intestinal wall, mucosal layer, and muscular layer in each group were measured by high-frequency ultrasonography and recorded in detail. During the operation, a stent was placed under real-time guidance, and the situation in the cavity was observed. The clinical data of the two groups of children before and after the operation were collected, and the recurrence status after treatment was followed up.
RESULTS
Endoscopic treatment was completed in 131 patients with a success rate of 96.32%. There was no significant difference between the two groups in appendix diameter, intestinal wall, or muscular layer after the operation when compared to those before the operation (p > 0.05), but there was a significant difference in the mucosal thickness after operation when compared to before the operation (p < 0.05). Abdominal pain in the two groups was significantly relieved immediately after the operation, and the white blood cell count returned to normal, with a significant difference before and after the ERAT operation (p < 0.05).
CONCLUSION
Endoscopic intra-appendiceal irrigation under the guidance of high-frequency ultrasonography is a real-time and convenient method that is safe and effective in treating pediatric acute appendicitis.
Identifiants
pubmed: 36690894
doi: 10.1007/s00464-022-09779-6
pii: 10.1007/s00464-022-09779-6
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
3814-3822Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
Références
Podda M, Poillucci G, Pacella D, Mortola L, Canfora A, Aresu S, Pisano M, Erdas E, Pisanu A, Cillara N (2021) Appendectomy versus conservative treatment with antibiotics for patients with uncomplicated acute appendicitis: a propensity score-matched analysis of patient-centered outcomes (the ACTUAA prospective multicenter trial). Int J Colorectal Dis 36(3):589–598
doi: 10.1007/s00384-021-03843-8
pubmed: 33454817
Glass CC, Rangel SJ (2016) Overview and diagnosis of acute appendicitis in children. Semin Pediatr Surg 25(4):198–203
doi: 10.1053/j.sempedsurg.2016.05.001
pubmed: 27521708
Liu B, Ma X, Feng J, Yang Z, Bo Qu, Feng Z, Ma S, Yin J, Sun R, Guo L, Liu W (2015) Endoscopic retrograde appendicitis therapy (ERAT): a multicenter retrospective study in China [J]. Surg Endosc 29:905–909
doi: 10.1007/s00464-014-3750-0
pubmed: 25106722
Randal Bollinger R, Barbas AS, Bush EL, Lin SS, Parker W (2007) Biofilms in the large bowel suggest an apparent function of the human vermiform appendix. J Theor Biol 249:826–831
doi: 10.1016/j.jtbi.2007.08.032
pubmed: 17936308
Ding W, Zhiqiang Du, Zhou X (2022) Endoscopic retrograde appendicitis therapy for management of acute appendicitis. Surg Endosc 36(4):2480–2487
doi: 10.1007/s00464-021-08533-8
pubmed: 33983458
Zisman A, Novi B (2022) John Gaughan and Lauren Carr (2022) Factors affecting utilization of CT scan following ultrasound evaluation of suspected appendicitis. J Osteopath Med 122(6):313–318
doi: 10.1515/jom-2021-0251
pubmed: 35245969
Kang J, Zhang W, Zeng L, Lin Y, Junqing Wu, Zhang N, Xiaomin Xie Yu, Zhang XL, Wang B, Yang R, Jiang X (2021) The modified endoscopic retrograde appendicitis therapy versus antibiotic therapy alone for acute uncomplicated appendicitis in children. Surg Endosc 35(11):6291–6299
doi: 10.1007/s00464-020-08129-8
pubmed: 33146811
Peter C Minneci, Erinn M Hade, Amy E Lawrence, Yuri V Sebastião, Jacqueline M Saito, Grace Z Mak, Christa Fox, Ronald B Hirschl, Samir Gadepalli, Michael A Helmrath, Jonathan E Kohler, Charles M Leys, Thomas T Sato, Dave R Lal, Matthew P Landman, Rashmi Kabre, Mary E Fallat, Jennifer N Cooper, Katherine J Deans, Midwest Pediatric Surgery Consortium (2020) Association of nonoperative management using antibiotic therapy vs laparoscopic appendectomy with treatment success and disability days in children with uncomplicated appendicitis. JAMA 324(6):581–593
doi: 10.1001/jama.2020.10888
Song M-Y, Ullah S, Hui-Yu Yang Md, Ahmed R, Saleh A-A, Liu B-R (2021) Long-term effects of appendectomy in humans: is it the optimal management of appendicitis? Expert Rev Gastroenterol Hepatol 15(6):657–664
doi: 10.1080/17474124.2021.1868298
pubmed: 33350352
Wenqi C, Xuan Z, Zhang Qian Xu, Jianglei LC (2022) The application of dual-pathway Contrast-Enhanced Ultrasound (CEUS) in the treatment of periappendiceal abscesses [J]. J Ultrasound. https://doi.org/10.1007/s40477-022-00692-1
doi: 10.1007/s40477-022-00692-1
Linam LE, Munden M (2012) (2012) Sonography in children with suspected acute appendicitis. The American Institute of Ultrasound in Medicine. J Ultrasound Med 31:1153–1157
doi: 10.7863/jum.2012.31.8.1153
pubmed: 22837278
Preetam G, Bellah RD (2017) Ultrasound of the pediatric appendix. [J]. Pediatric Radiol 47:1091–1100
doi: 10.1007/s00247-017-3928-4