Modern tendencies in diagnostics and treatment of destructive appendicitis
https://doi.org/10.24884/0042-4625-2017-176-3-67-73
Abstract
OBJECTIVE. The authors analyzed the personal treatment management, which was focused on the priority application of low invasive surgical methods in patients with destructive and complicated appendicitis. MATERIAL AND METHODS. The results of treatment of 803 patients with acute appendicitis were investigated in prospective study. Patients were stratified according to the presence of complicated forms of acute appendicitis and the method of treatment. RESULTS. Laparoscopic appendectomy was performed in 93 % cases and conversion of access was carried out in 6 % cases. The rates of postsurgical complications and wound infection were 1,6 % and 0,7 %, respectively. The indices were lower than in case of open appendectomy 8,4 % and 6,3 % (р < 0,05), respectively. The level of complications was 6 % in application of percutaneous drainage in periappendiceal abscess. Nonsurgical treatment of circumscribed appendiceal mass was effective in 91,9 %. CONCLUSIONS. Realization of given personal approach allowed doctors to use the whole range of minimally invasive techniques in more adequate way. The results of treatment indicated its validity.
About the Authors
N. A. Maistrenko
S. M. Kirov Military Medical Academy
Russian Federation
Russian Federation
P. N. Romashchenko
S. M. Kirov Military Medical Academy
Russian Federation
Russian Federation
M. V. Yagin
S. M. Kirov Military Medical Academy
Russian Federation
Russian Federation
References
1. Майстренко Н. А., Ромащенко П. Н., Ягин М. В. Аппендикулярный инфильтрат : диагностика и лечение // Вестник хирургии. 2016. № 5. С. 57-63.
2. Седов В. М., Бохан К. Л., Гостевской А. А. Болезни червеобразного отростка. СПб. : Человек, 2016. 338 с.
3. Фёдоров А. В., Оловянный В. Е. Лапароскопическая хирургия в регионах России : проблемы и пути развития // Хирургия. 2011. № 6. С. 4-10.
4. Andersson M., Andersson R. Causes of short-term mortality after appendectomy : a population-based case-controlled study // Ann. Surg. 2011. Vol. 254, № 1. P. 103-107. doi: 10.1097/ SLA.0b013e31821ad9c4.
5. Andersson R., Petzold M. Nonsurgical treatment of appendiceal abscess or phlegmon : a systematic review and meta-analysis // Ann. Surg. 2007. Vol. 246, № 5. P. 741-748.
6. Antonacci N., Ricci C., Taffurelli G., Monari F., Del Governatore M., Caira A., Leone A., Cervellera M., Minni F., Cola B. Laparoscopic appendectomy: which factors are predictors of conversion? A high-volume prospective cohort study // Int. J. Surg. 2015 Vol. 21. P. 103-107. doi: 10.1016/j.ijsu.2015.06.089.
7. Bhangu A., Begai I., Ray D. Population level analysis of diagnostic laparoscopy versus normal appendicectomy for acute lower abdominal pain // Int. J. Surg. 2014 Vol. 12, № 12. P. 1374-1379. doi: 10.1016/j.ijsu.2014.10.017.
8. Bhangu А., Søreide K., Di Saverio S., Assarsson J., Drake F. Acute appendicitis : modern understanding of pathogenesis, diagnosis, and management // Lancet. 2015. Vol. 386, № 10 000. P. 1278-1287. doi: 10.1016/S0140-6736(15)00275-5.
9. Deelder J., Richir M., Schoorl T., Schreurs W. How to treat an appendiceal inflammatory mass: operatively or nonoperatively? // J. Gasrointest. Surg. 2014. Vol. 18, № 4. P. 641-645. doi: 10.1007/ s11605-014-2460-1.
10. Ingraham A., Cohen M., Bilimoria K., Pritts T., Ko C., Esposito T. Comparison of outcomes after laparoscopic versus open appendectomy for acute appendicitis at 222 ACS NSQIP hospitals // Surgery. 2010. Vol. 148, № 4. P. 625-635. doi: 10.1016/j.surg.2010.07.025.
11. Korndorffer J., Fellinger E., Reed W. SAGES guidelines for laparoscopic appendectomy // Surg. Endosc. 2010. Vol. 24, № 4. P. 757-761. doi: 10.1007/s00464-009-0632-y.
12. Lin H., Lai H., Lai I. Laparoscopic treatment of perforated appendicitis // World J. Gastroenterol. 2014. Vol. 20, № 39. P. 14338-14347 (doi: 10.3748/wjg.v20.i39.14338).
13. Masoomi H., Mills S., Dolich M., Ketana N., Carmichael J., Nguyen N., Stamos M. Comparison of outcomes of laparoscopic versus open appendectomy in adults : data from the Nationwide Inpatient Sample (NIS), 2006-2008 // J. Gastrointest. Surg. 2011. Vol. 15, № 12. P. 2226-2231. doi: 10.1007/s11605-011-1613-8.
14. Olsen J., Skovdal J., Qvist N., Bisgaard T. Treatment of appendiceal mass - a qualitative systematic review // Dan. Med. J. 2014. Vol. 61, № 8. P. 1-9.
15. Page A., Pollock J., Perez S., Davis S., Lin E., Sweeney J. Lapa roscopic versus open appendectomy : an analysis of outcomes in 17, 199 patients using ACS/NSQIP // J. Gastrointest. Surg. 2010. Vol. 14, № 12. P. 1955-1962. doi: 10.1007/s11605-010-1300-1.
16. Rather S., Bari S., Malik A., Khan A. Drainage vs no drainage in secondary peritonitis with sepsis following complicated appendicitis in adults in the modern era of antibiotics // World J. Gastrointest. Surg. 2013. Vol. 5, № 11. P. 300-305. doi: 10.4240/wjgs.v5.i11.300.
17. Saar S., Talving P., Laos J., Põdramägi T., Sokirjanski M., Lustenberger T., Lam L., Lepner U. Delay between onset of symptoms and surgery in acute appendicitis increases perioperative morbidity : a prospective study // World J. Surg. 2016. Vol. 40, № 6. P. 1308-1314. doi: 10.1007/s00268-016-3416-2.
18. Sartelli M., Viale P., Catena F. WSES guidelines for management of intra-abdominal infections // World J. Emerg. Surg. 2013. Vol. 8, № 1. P. 1-29. doi: 10.1186/1749-7922-8-3.
19. Sauerland S., Jaschinski T., Neugebauer E. A. Laparoscopic versus open surgery for suspected appendicitis // Cochrane Database Syst. Rev. 2010. Vol. 6, № 10. doi: 10.1002/14651858.CD001546.pub3.
20. Solomkin J., Mazuski J., Bradley J., Rodvold K., Goldstein E., Baron E., O’Neill P., Chow A., Dellinger E., Eachempati S., Gorbach S., Hilfiker M., May A., Nathens A., Sawyer R., Bart lett J. Dia gnosis and management of complicated intra-abdominal infection in adults and children : guidelines by the Surgical Infection Society and the Infectious Diseases Society of America // Clin. Infect. Dis. 2010. Vol. 50, № 2. P. 133-164. doi: 10.1089/sur.2009.9930.
21. Stefanidis D., Richardson W., Chang L., Earle D., Fanelli R. The role of diagnostic laparoscopy for acute abdominal conditions : an evidence-based review // Surg. Endosc. 2009. Vol. 23, № 1. Р. 16-23. doi: 10.1007/s00464-008-0103-x.
22. Tannoury J., Abboud B. Treatment options of inflammatory appendiceal masses in adults // World J. Gastroenterol. 2013. Vol. 19, № 25. P. 3942-3950. doi: 10.3748/wjg.v19.i25.3942.
23. Tiwari M., Reynoso J., Tsang A., Oleynikov D. Comparison of out comes of laparoscopic and open appendectomy in management of un complicated and complicated appendicitis // Ann. Surg. 2011. Vol. 254, № 6. P. 927-932. doi: 10.1097/SLA.0b013e31822aa8ea.
24. van Rossem С., Schreinemacher M., Treskes K., van Hogezand R., van Geloven A. Duration of antibiotic treatment after appendicectomy for acute complicated appendicitis // Brit. J. Surg. 2014. Vol. 101, № 6. P. 715-719. doi: 10.1002/bjs.9481.
Review
For citations:
Maistrenko N.A., Romashchenko P.N., Yagin M.V. Modern tendencies in diagnostics and treatment of destructive appendicitis. Grekov's Bulletin of Surgery. 2017;176(3):67-73. (In Russ.) https://doi.org/10.24884/0042-4625-2017-176-3-67-73
Views:
911
Email this article 