Extending the Application of Interval Appendectomy for Acute Appendicitis

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  • Kano Motohiro
    Department of Surgery, Tokyo Metropolitan Children’s Medical Center
  • Komori Koji
    Department of Surgery, Tokyo Metropolitan Children’s Medical Center
  • Shimojima Naoki
    Department of Surgery, Tokyo Metropolitan Children’s Medical Center
  • Yamamoto Yuki
    Department of Surgery, Tokyo Metropolitan Children’s Medical Center
  • Ogata Satsuki
    Department of Surgery, Tokyo Metropolitan Children’s Medical Center
  • Hirobe Seiichi
    Department of Surgery, Tokyo Metropolitan Children’s Medical Center

Bibliographic Information

Other Title
  • 急性虫垂炎に対するinterval appendectomyの適応
  • 急性虫垂炎に対するinterval appendectomyの適応 : どこまで適応を拡大できるか
  • キュウセイ チュウスイエン ニ タイスル interval appendectomy ノ テキオウ : ドコ マデ テキオウ オ カクダイ デキル カ
  • ―どこまで適応を拡大できるか―

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<p>Purpose: There are many reports that describe the usefulness of interval appendectomy (IA), as it reduces complications during the perioperative period. Its usefulness is well accepted when it is applied to perforated appendicitis; however, its other applications are still unclear. The aim of this study is to examine the validity of our new IA protocols and patient selection retrospectively.</p><p>Methods: Patients who had symptoms of complicated appendicitis for more than 48 hrs and treated at our hospital from January 2012 to December 2013 were retrospectively analyzed. We divided them into two groups: Group E (treated in 2012 and emergent appendectomy was performed) and Group IA (treated in 2013 and IA was performed). We compared and statistically examined age, sex, pain control, laboratory data, operation time, intraoperative bleeding, length of hospital stay, and complications of the two groups.</p><p>Results: There were 10 patients in each group. Operation time was significantly shorter in Group IA (58.6 min) than in Group E (96.7 min). There was no complication in Group IA, whereas two complications were observed in Group E. Initial conservative treatment took 8.8 days in Group IA and no recurrence was observed during the waiting period. Total hospital stays were 10.2 days for Group E and 12.8 days for Group IA, which were not significantly different.</p><p>Conclusions: Using our criteria, we could have treated our high-risk appendicitis patients with IA safely without lengthening the hospital stay, which indicates that a more extensive IA application to late-presenting complicated appendicitis is possible.</p>

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