Acute appendicitis is the most common cause of abdominal pain requiring surgical emergency with a reported life time incidence of 8%. Thus, appendectomies are among most frequent abdominal procedures performed by general surgeons. Laparoscopic appendectomy has become the gold standard of treatment of acute appendicitis. Therefore, further research should focus on improving operative technique, identification of risk factors of peri- and postoperative morbidity and should present outcomes in selected groups of patients (eg. elderly or patients with complicated appendicitis). This series of publications will focus on these aspects.The aim of the study was to identify factors influencing outcomes of laparoscopic appendectomy based on results from multicenter cohort Pol-LA study (Polish Laparoscopic Appendectomy). Between 2017 and 2018 multicenter cohort study Pol-LA(Polish Laparoscopic Appendectomy) was conducted. It included 4618 patients undergoing laparoscopic appendectomy for acute appendicitis. Results and conclusions The results showed that differences in clinical presentation, patients’ age and operative technique may have influence on outcomes of laparoscopic appendectomy. Identification of patients with high risk of poor clinical outcomes is crucial. This group includes elderly and those with risk factors of complicated appendicitis. Outcomes of laparoscopic appendectomy ; differ depending on patients’ age because the risk of complicated appendicitis increases with patients’ age. Closure of appendiceal stump with stapler may be associated with better outcomes of laparoscopic appendectomy in patients with complicated appendicitis. Complicated appendicitis is connected to worse outcomes of laparoscopic appendectomy. The risk factors for this condition include: female sex, age > 50 years, symptoms duration >48 h, higher Alvarado score and CRP > 100 mg/l. Postoperative intraabdominal abscess formation is associated with poor outcomes of laparoscopic appendectomy and complicated appendicitis is the strongest risk factor for this complication.
Pędziwiatr, Michał ; Rubinkiewicz, Mateusz
Jun 26, 2023
Aug 6, 2020
54
0
http://dl.cm-uj.krakow.pl:8080/publication/4365
Edition name | Date |
---|---|
ZB-131960 | Jun 26, 2023 |
Lasek, Anna
Dorobek, Adam
Orłowski, Paweł
Natkaniec, Michał
Sulisławski, Janusz
Bogusz, Bartosz
Pisarska-Adamczyk, Magdalena
Witowski, Jan Sylwester