Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “APPENDECTOMY”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 433 records · Page 24Linked to original sources
PubMed1999

Laparoscopic versus open appendectomy: prospective randomized trial.

Although classic open surgery is simple, expeditious, and effective, it has some drawbacks, including wound sepsis, delayed recovery, operative difficulties, and possibility of unnecessary appendectomies for false appendicitis. The aim of this study was to assess the applicability and safety of laparoscopic appendectomy (LA) in a prospectively randomized trial. Seventy nonselective patients with suspected appendicitis were randomized to laparoscopic (n = 35, 17 male) or open appendectomy (n = 35, 15 male) and operated on an emergency basis. Operative findings, operating time, postoperative complications, and length of hospital stay were compared. We found that LA is associated with a shorter hospital stay, fewer postoperative complications, and better diagnostic accuracy, and it is recommended as the procedure of choice for the diagnosis and management of acute appendicitis.

Adult↗
PubMed2000

Is there a role for interval appendectomy in the management of acute appendicitis?

Interval appendectomy (IA) remains a controversial subject in surgery. To determine its effectiveness we reviewed our results with this approach. From January 1990 through December 1998 a total of 73 patients underwent appendectomy, five (7%) of which were interval in nature. These IA patients had a palpable abdominal mass or delayed presentation that led to CT scan. The decision to delay surgery was determined by two factors: 1) a CT scan that showed advanced inflammatory changes (phlegmon or abscess) associated with acute appendicitis and 2) a rapid response to conservative management. All patients received antibiotics-first intravenous and then oral. Repeat CT scans were performed before surgery and showed a virtual resolution of the inflammatory process. Appendectomy was delayed from 35 to 66 days from the time of diagnosis (average 51 days). There were no preoperative complications, the operations were uneventful, and there were no significant postoperative sequelae. IA appears to convert an unfavorable surgical situation potentially fraught with complications (fistula, abscess, wound infection) to one that is essentially elective in nature. It should be considered for the patient who is found to have an extensive periappendiceal inflammatory process, is clinically stable, and responds favorably to initial nonoperative management.

Acute Disease↗
PubMed2001

A comparison of an open and laparoscopic appendectomy for patients with liver cirrhosis.

Liver cirrhosis is a critical factor contributing to morbidity and mortality in abdominal surgery, because patients with cirrhosis have a particularly high risk of developing bleeding, infection, and ascites. Laparoscopic appendectomy (LA) recently has gained a lot of attention around the world; however, comparisons between the benefits of LA and those of conventional open appendectomy (OA) for patients with liver cirrhosis have yet to be sufficiently compiled. In the present retrospective study, 40 patients with liver cirrhosis who were diagnosed with acute appendicitis before surgery underwent an appendectomy (OA in 25 patients and LA in 15 patients). This study focused on the operative time, amount of postoperative pain, use of analgesics, the restart of a normal diet, number of complications, length of hospital stay, and cost-effectiveness of the procedure in such patients. The amount of postoperative pain and the length of hospital stay were significantly smaller in the LA group. The mean values of the serum C-reactive protein on postoperative days 1, 3, and 7 were significantly less in the LA group. The number of wound infections and wound bleeding was also less in the LA group. The difference in the total cost of hospitalization was not significant. The cost of the operation was greater in the LA group than in the OA group, whereas the hospitalization cost in the LA group was less than that in the OA group. The results of this study suggest that LA may be superior to OA for the treatment of postoperative pain and postoperative complications for patients with liver cirrhosis. Long-term follow-up studies are still necessary, however, to determine any possible decrease in the number of late complications.

Aged↗
PubMed2001

[Significant change in the number of appendectomies performed in Hungary during the last four decades].

The number of appendectomies carried out annually in Hungary diminished significantly during the last four decades till middle of nineties. From 1995 the annually number of appendectomies is hardly higher than a quarter of the number of operations in 1961. The reasons of this situation may be the improvement of diagnostic of appendicitis, as well as the rarer occurrence of this disease. In the changes of incidence of appendicitis the anti-bacterial treatments carried out in different reasons may be important factors. These treatments can change in composition of normal bowel bacterial flora. At the same time, when the number of appendectomies is diminishing the number of chronic bowel inflammations (e.g. Crohn disease, colitis ulcerosa) is increasing, this situation may be different sides of the same process.

Appendectomy↗
PubMed2001

[Prophylactic appendectomy with invagination during cesarean section].

OBJECTIVE: To evaluate the impact of the prophylactic appendectomy acComplished during cesarean section about postoperative morbidity. METHODS AND MATERIALS: Fifty-nine patients with pregnancy at term and had a cesarean section were randomized in two groups: Group I: Twenty-nine patients subjected to cesarean section as well as prophylactic appendectomy with invaginant technic and Group II: Thirty patients subjected just to cesarean section. The analyzed variables were: surgical time, hospitable stay and postoperative morbidity. RESULTS: Surgical time were similar between two groups (means: 56.75 min vs. 53.96 min to group I and II). The means of the hospitable stay was 29.98 hours (SD +/- I 1.81) and 27.72 hours (SD +/- 6.91) to Group I and II respectively, without significant differences statisTIcally between the groups. There were no postoperative morbidity in any group. CONCLUSIONS: Cesarean section plus prophylactic appendectomy with invaginant technic is an easy and safe procedure to be performed. It does not produce postoperative morbidity, besides it does not increase surgical time and hospitable stay.

Adolescent↗
PubMed2002

Laparoscopic appendectomy: indications and controversies.

The introduction of laparoscopic appendectomy has been more controversial than that of laparoscopic cholecystectomy. Randomized trials have been performed, as well as meta-analysis, with equivocal results regarding effectiveness. The further expansion of the technique for interval appendectomy and in cases of complicated appendicitis has introduced new controversies and success stories. We hope to review the current application of laparoscopic appendectomy in adults based on the available literature and discuss some current controversies.

Adult↗
PubMedDate not supplied

Minilaparoscopic cystectomy and appendectomy in late second trimester.

BACKGROUND AND OBJECTIVES: Laparoscopic ovarian cystectomy and appendectomy during the early second trimester have been widely reported. However, the use of both procedures in advanced gestation is rare. We propose a minilaparoscopic approach for performing these 2 procedures in a woman 24-weeks pregnant. METHODS: We describe the case and laparoscopic management of acute abdominal pain at the 24th week of pregnancy. Microlaparoscopy under ultrasound guidance was used for the first trocar insertion to prevent injury to the uterus. It was followed by minilaparoscopic ovarian cystectomy and appendectomy. RESULTS: Premature contractions occurred after the operation, but they were controlled with a single tocolytic agent, and an apparently healthy female baby was born uneventfully via Cesarean delivery at 41 weeks of gestation. CONCLUSION: Minilaparoscopic ovarian cystectomy and appendectomy can be carried out in the late second trimester without serious sequela.

Abdominal Pain↗
PubMed2002

Laparoscopic versus open appendectomy in females with a clinical diagnosis of appendicitis.

OBJECTIVE: Appendectomy can be performed using either a laparoscopic technique (LT) or an open technique (OT). We compared the following items operative, anesthesia, length of stay, post-operative pain, medicine, wound healing, days to return to normal activity in both groups. METHODS: This study was carried out at King Fahad Hospital, Hofuf, Al-Hassa, Kingdom of Saudi Arabia, from January 1999 to April 2000. We randomly assigned 60 female patients to appendectomy by LT or OT. The 2 groups were compared concerning demographic data. The differences were considered statistically significant at a P value < 0.05. RESULTS: The open group had shorter anesthesia and operative time (68, 50 versus 85, 65 minutes). The laparoscopic group had a significant reduced postoperative narcotic requirement (P<0.05), quicker reintroduction of diet and quicker return to normal activity. CONCLUSION: Laparoscopic appendectomy in female patients with clinical diagnosis of appendicitis is the procedure of choice for the diagnosis and the management of acute appendicitis.

Adolescent↗
PubMedDate not supplied

Laparoscopic appendectomy.

This study contains a brief review of the changes in the technique of laparoscopic appendectomy. The authors' experiences with the methods they applied are reported. The authors emphasize on the benefits of laparoscopic appendectomy as opposed to traditional appendectomy, and advocate its wide-range application.

Adolescent↗
PubMed1992

[Appendectomy, a risk factor for ectopic pregnancy].

As part of a case-control study of ectopic pregnancy, we evaluated the potential etiological role of appendectomy. Previous appendectomy was associated with an increased risk of ectopic pregnancy (adjusted Odds-ratio: 2.2; 95 percent CI: 1.5-3.2). Ruptured appendix did not appear to be more strongly associated with an increased risk of ectopic pregnancy than unruptured appendix. Such confounding factors as absence of pathological diagnosis of appendicitis and relationship between age of appendectomy and age of first sexual intercourse are discussed. This study provides an additional argument in favor of laparoscopy in childbearing age to diagnose appendicitis and salpingitis.

Adolescent↗
PubMedDate not supplied

Fifty-five consecutive laparoscopic appendectomy procedures without conversion.

BACKGROUND: In patients with suspected appendicitis, laparoscopic appendectomy is gaining increasing acceptance primarily because it is associated with less postoperative pain and a shorter hospital stay. Experience with 55 consecutive laparoscopic appendectomies, performed without conversion by the same surgeon, is herein examined and analyzed. METHODS: The medical records of 55 consecutive patients with suspected appendicitis who underwent laparoscopic exploration (from 2000 to 2002) were analyzed for demographic information, clinical findings, laboratory/computed tomography scan results, intraoperative diagnosis, clinicopathologic correlation, complications, incidental findings, and operative time. RESULTS: Twenty-six males (47%) and 24 females (53%) underwent surgery. Mean age was 25.2 years (range, 6 years to 67 years). Computerized tomography scans obtained in 37 cases (74%) had a sensitivity of 86.7% and a specificity of 62.5%. Average length of stay was 2.3 days (median, 1 day). Average operating room time was 69 minutes (range, 40 to 173 minutes). Five patients experienced postoperative complications: 2 had intraperitoneal abscesses, 1 had urinary retention, and 2 had postoperative ileus. No operative conversions or postoperative wound infections occurred. CONCLUSION: Laparoscopy confirmed the clinical diagnosis of acute appendicitis and allowed the safe, effective treatment of both complicated and uncomplicated appendicitis with minimal hospitalization, recovery and convalescent times, and zero open conversion and wound infections. Laparoscopic appendectomy is advocated as the procedure of choice for patients with clinically suspected appendicitis.

Adolescent↗
PubMedDate not supplied

[Laparoscopic appendectomy: retrospective studies of 172 consecutive procedures].

The aim of our study was to assess the efficacy and safety of laparoscopic appendectomy, as performed by experienced and trainee surgeons in a Unit of General Surgery. From June 1997 to May 2002, 172 patients underwent laparoscopic appendectomy. Age below 13 years was an exclusion criterion. There was no single protocol for the diagnosis and surgical technique adopted by the different surgeons. The average operating time was 65.3 min (range: 41-106 min). There were 9 conversions to open surgery (5.2%) and 9 postoperative complications (5.5%) out of a total of 162 patients undergoing the laparoscopic procedure. Oral intake was resumed on post-operative day 2 and the average hospital stay was 3.4 days (range: 3-5 days). In conclusion, laparoscopic appendectomy proved to be safe and effective, even when performed by surgeons with only limited experience of minimally invasive surgery.

Adolescent↗
PubMed2004

[Indication of appendectomy in the recurrent abdominal pain].

INTRODUCTION: The frequency of the recurrent abdominal pain without demonstrable pathology is high and in occasions it takes to the surgeon to practice an appendectomy. In most of the cases the pain disappears. This performance although subjective, it doesn't base on objective data, what takes us to carry out this work. MATERIAL AND METHOD: The study is carried out in 47 patients with recurrent abdominal pain and subjected to appendectomy, 17 were excluded by diverse causes. The vermiform appendixes were studied by morphological and immunohistochemical methods, using the monoclonal antibodies, valuing morphologic sing of a chronic inflammation of the appendix. RESULTS: 100% of the samples studied presented microscopically chronic inflammatory changes microscopically. We observe fibrose in 100%, lympho-plasmocytic inflammatory infiltrate in 60% and a lymphocytes T prevalence has more than enough lymphocytes B. CONCLUSIONS: Our results support the existence of a clinical-pathological condition that can be defined as chronic appendicitis and therefore it justifies the appendectomy in recurrent abdominal pain when another disease has been excluded.

Abdominal Pain↗
PubMed1992

[Laparoscopic appendectomy].

We have performed the first laparoscopic appendectomy in Hungary. Laparoscopic appendectomy is a new, minimally invasive method in abdominal surgery. We consider it a worthwhile alternative to classical appendectomy.

Adolescent↗
PubMed2004

Infection after cholecystectomy, hysterectomy or appendectomy.

OBJECTIVES: This article uses patient-linked data to focus on hospitalization with post-operative infection following cholecystectomy, hysterectomy or appendectomy. The average number of hospital days and the costs of readmission are also estimated. DATA SOURCE: Data for surgeries in fiscal years 1997/98, 1998/99 and 1999/00 are from the Health Person-Oriented Information Database. ANALYTICAL TECHNIQUES: Bivariate tabulations were used to estimate the percentage of patients hospitalized with post-operative infection after cholecystectomy, hysterectomy or appendectomy between 1997/98 and 1999/00. Logistic regression was used to explore associations between infection and patient characteristics, readmission, and peri-operative mortality, while controlling for surgical characteristics. MAIN RESULTS: Hospitalization with post-operative infection was relatively rare, occurring in 1.4% of cholecystectomy, 2.0% of hysterectomy, and 3.8% of appendectomy patients. The associated costs of readmission for post-operative infection for the three surgeries were estimated at 5.4 to 6.3 million dollars annually. Old age, being male, surgical complexity and approach, and diabetes were associated with hospitalization involving a post-operative infection.

Adult↗
PubMed2004

Outcomes of laparoscopic versus open appendectomy.

Controversy remains regarding which approach is better, laparoscopic appendectomy (LA) or open appendectomy (OA). A 5-year retrospective review of patients undergoing appendectomy was performed to compare the outcomes of LA and OA using standard statistical methods (P < 0.05). LA was performed in 207 and OA in 100 patients (conversion 6.7%). Females underwent LA more frequently than males (81.7% vs 51.9%; P = 0.0001). LA patients were older (30.2 years vs 25.7 years; P = 0.03), with no differences in body mass index (BMI) (27.9 kg/m2 vs 25.5 kg/m2; P = 0.06) or operative times (51.1 minutes vs 51.5 minutes; P = 0.84). LA patients required less analgesics (19.2 mg vs 31.5 mg; P = 0.01), and shorter hospital stays (27.2 hours vs 53.1 hours; P = 0.0001). Operating room charges were higher for LA (3839 dollars vs 2528 dollars; P = 0.0001), with no difference in total hospital charges (8801 dollars vs 9147 dollars; P = 0.14). Complications between LA and OA were similar (3.6% vs 8%; P = 0.12). Converted patients were older, required more analgesia, and had higher morbidity, length of stay, and hospital charges. LA is the procedure of choice for appendicitis regardless of age, sex, BMI, or degree of appendiceal inflammation. LA is as safe and quick to perform as OA with lower analgesic requirements, length of stay, and no difference in total charges.

Adult↗
PubMed2005

Laparoscopic versus open appendectomy: is the postoperative infectious complication rate different?

Despite the reported advantages of laparoscopic appendectomy (LA), there is debate about the postoperative infectious complication rate. Our study attempts to determine if the infectious complication rate between LA and open appendectomy (OA) is different. A retrospective review was conducted of all patients who underwent appendectomy at Kern Medical Center between 1999 and 2003. Age, sex, white blood cell count, temperature, pathology, and postoperative complications were identified. Fifty-seven patients underwent LA, and 159 patients underwent OA. The groups were well matched for demographics, white blood cell count, temperature, and percent perforated appendicitis. There was an overall 9.3 per cent complication rate. The infectious complication rate in OA versus LA group was statistically different (6.3% vs 17.6%, P = 0.04). The infectious complication rate in the LA group was significantly higher than in the OA group. Further large randomized trials are necessary to confirm our findings and to identify if LA is appropriate for a subset of appendicitis patients.

Adolescent↗
PubMed1991

Laparoscopic incidental appendectomy.

The benefits and risks of laparoscopic incidental appendectomy are discussed. We believe a case for laparoscopic incidental appendectomy can be made for patients undergoing diagnostic laparoscopy for lower abdominal pain in whom either no cause is found, or in whom a cause other than appendicitis is discovered. No benefit from incidental appendectomy can be shown for patients undergoing laparoscopy for other disorders.

Abdominal Pain↗