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Surg Endosc 2019 Mar 12. Epub 2019 Mar 12.

Department of Surgery, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Charité Campus Mitte, Campus Virchow Klinikum, Charitéplatz 1, 10117, Berlin, Germany.

Background: Single-incision laparoscopic surgery (SILS) is growing in popularity. The increased diameter of the umbilical incision might raise questions about the possibility of a greater risk of postoperative incisional hernia in comparison to conventional laparoscopy. This study aims to disclose the frequency of incisional hernia after SILS in long-term follow-up as well as to reveal the factors predisposing patients to this feared complication. Read More

Surgery 2019 Mar 8. Epub 2019 Mar 8.

Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA.

Ann R Coll Surg Engl 2019 Mar 11:1-16. Epub 2019 Mar 11.

Laboratory of Experimental Surgery and Surgical Research, National and Kapodistrian University of Athens , Greece.

Introduction: Acute appendicitis is a common and serious situation during pregnancy, because of the increased risk of fetal loss and perforation in the third trimester, as well as a diagnostic difficulty. During recent years laparoscopic approach has been introduced to clinical practice with encouraging results. The purpose of this meta-analysis is to compare the surgical and obstetrical outcomes between laparoscopic and open appendectomy during pregnancy. Read More

Bull Cancer 2019 Mar 5. Epub 2019 Mar 5.

AP-HP, institut universitaire de cancérologie Sorbonne université, service de gynécologie-obstétrique et médecine de la reproduction, hôpital Tenon, UMRS-938, 4, rue de La Chine, 75020 Tenon, France.

Faced to an undetermined ovarian mass on ultrasound, an MRI is recommended and the ROMA score (combining CA125 and HE4) can be proposed (grade A). In case of suspected early stage ovarian or fallopian tube cancer, omentectomy (at least infracolonic), appendectomy, multiple peritoneal biopsies, peritoneal cytology (grade C) and pelvic and para-aortic lymphadenectomy are recommended (grade B) for all histological types, except for the expansive mucinous subtype where lymphadenectomy may be omitted (grade C). Minimally invasive surgery is recommended for early stage ovarian cancer, if there is no risk of tumor rupture (grade B). Read More

JSLS 2019 Jan-Mar;23(1)

Department of Pediatric Surgery, University Medical Center of the Johannes Gutenberg University Mainz, Germany.

Background And Objectives: The aim of the study was to investigate a potential association between previous childhood appendectomy, tube pathology, and female infertility.

Methods: We reviewed patients seeking care at the fertility clinic of our university medical center between 2006 and 2016. The history of previous appendectomy was extracted from hospital documentation and by telephone follow-up. Read More

J Gastrointest Surg 2019 Mar 6. Epub 2019 Mar 6.

Department of Surgery, Anne Arundel Medical Center, 2000 Medical Pkwy, Annapolis, MD, 21401, USA.

Background: Bundled payments are increasingly becoming common in surgery, yet little is known regarding their potential impact on reimbursements for patients presenting with acute appendicitis. This study examines the financial impact of bundled payments for acute appendicitis.

Methods: This was a retrospective review of all open or laparoscopic appendectomies between July 2014 and June 2017. Read More

Am Surg 2019 Feb;85(2):e97-e99

Surg Endosc 2019 Feb 25. Epub 2019 Feb 25.

Department of Surgery, University Surgical Cluster, National University Hospital, Singapore, Singapore.

Background: Acute appendicitis is a common condition in the pediatric population. In patients with uncomplicated appendicitis, laparoscopic appendectomy (LA) is preferred as compared to open appendectomy (OA). However, in patients with complicated appendicitis (CA), as defined as suppurative, gangrenous or perforated appendicitis, or appendicitis with periappendicular abscess formation, the decision to perform OA or LA remains unclear. Read More

J Pediatr Surg 2019 Feb 4. Epub 2019 Feb 4.

Department of Surgery, Schulich School of Medicine and Dentistry, Western University, 1151 Richmond St., London, Ontario, Canada, N6A 5C1. Electronic address:

Background: An extracorporeal (ECA), transumbilical appendectomy has been proposed as a treatment for appendicitis. This study assessed the 30-day perioperative outcomes and cost between ECA and traditional intracorporeal (ICA) techniques for acute uncomplicated appendicitis.

Methods: IRB approval was obtained for this retrospective cohort study of acute uncomplicated appendicitis in children aged 4 to 17 between April 2014 and April 2017. Read More

Khirurgiia (Mosk) 2019 (1):70-77

Pirogov Russian National Research Medical University of Healthcare Ministry of Russia, Moscow, Russia.

Acute appendicitis is the most frequent surgical disease complicating pregnancy. Accurate diagnosis is difficult due to atypical and misleading clinical manifestations. Surgeons frequently do not know about advantages and disadvantages of different diagnostic methods applied during pregnancy. Read More

Am J Surg 2019 Mar;217(3):483-484

Int J Surg 2019 Feb 12;64:1-4. Epub 2019 Feb 12.

Gastrounit - Surgical Division, Center for Surgical Research, Copenhagen University Hospital Hvidovre, Denmark; Institute of Clinical Medicine, University of Copenhagen, Denmark.

Background: In cases with clinically suspected appendicitis, there is controversy regarding the decision to remove a macroscopically normal appearing appendix during laparoscopy when no other intra-abdominal pathology is found. The aim of this study was to examine the rate of appendicitis, along with readmission and reoperation rates following diagnostic laparoscopy of clinically suspected appendicitis in patients where the appendix was not removed.

Methods: We performed a retrospective cohort analysis of patients who underwent a diagnostic laparoscopy due to clinical suspicion of appendicitis where no other pathology was found and the appendix was not removed. Read More

Wideochir Inne Tech Maloinwazyjne 2019 Jan 24;14(1):70-78. Epub 2018 Jul 24.

2 Department of General Surgery, Jagiellonian University Medical College, Krakow, Poland.

Introduction: According to meta-analyses laparoscopic appendectomy is associated with many benefits. However, in comparison to open surgery an increased rate of intraabdominal abscesses (IAA) has been reported. Identification of predictive factors for this complication may help to identify patients with higher risk of IAA. Read More

Am Surg 2019 Jan;85(1):76-81

The aim was to prospectively document the impact of early late appendectomy on intestinal function in pediatric perforated appendicitis. After Institutional Review Board approval, between September 2016 and August 2017, complete data were prospectively collected for children undergoing planned appendectomy for perforated appendicitis. One hundred children with pathologist-confirmed transmural perforations were included. Read More

Acta Chir Belg 2019 Feb 12:1-8. Epub 2019 Feb 12.

a 2nd Department of General Surgery , Jagiellonian University Medical College , Kraków , Poland.

Background: In general, the three main options for stump closure in laparoscopic appendectomy are clips, endoscopic staplers and endoloops. However, there is no gold standard, especially regarding complicated acute appendicitis which is generally associated with worse outcomes.

Objectives: We aimed to assess the outcomes of different stump closure techniques during laparoscopic appendectomies for complicated appendicitis Methods: Our multicenter observational study of 18 surgical units assessed the outcomes of 1269 laparoscopic appendectomies for complicated appendicitis that used the three main stump closure techniques: clips, staplers and endoloops. Read More

Ulus Travma Acil Cerrahi Derg 2019 Jan;25(1):34-38

Department of General Surgery, Dokuz Eylül University Faculty of Medicine, İzmir-Turkey.

Background: Stump closure is the most important part of a laparoscopic appendectomy (LA). Closing the appendix base with knot tying is the most cost-effective method. The defined risk factor for surgical site infection (SSI) after LA is the contamination of trocar entry area by inflamed appendicitis. Read More

Trauma Surg Acute Care Open 2019 24;4(1):e000243. Epub 2019 Jan 24.

Division of General Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.

A 57-year-old woman with morbid obesity (body mass index [BMI] of 43), systemic lupus on steroids, type 2 insulin-dependent diabetes, peripheral vascular disease, unprovoked pulmonary embolism on rivaroxaban, and hypertension presented with 3 days of worsening abdominal pain and nausea. She had an extensive surgical history including a cesarean section, multiple laparotomies for small bowel obstructions (one complicated by bowel perforation requiring resection), and a double-barrelled ileostomy, which had been since reversed. As a result, she had a massive incisional hernia (figure 1). Read More

J Surg Res 2019 Feb 6;238:57-63. Epub 2019 Feb 6.

Department of Surgery, Veterans Affairs Boston Healthcare System (112-C), Boston, Massachusetts. Electronic address:

Background: The present study was designed to implement and evaluate an interprofessional surgical technologist-to-surgical resident training program for junior general surgery residents aimed at enhancing their operating room skills. This program would be incorporated into the general surgery educational curriculum.

Material And Methods: Under the guidance and supervision of a surgical technologist, first-year and second-year general surgery residents performed the perioperative and intraoperative tasks that are the responsibilities of the surgical technologist for 16 inguinal/umbilical hernia and 15 laparoscopic appendectomy/cholecystectomy operations performed by attending surgeons assisted by other surgical residents from June 01, 2017 until December 31, 2017. Read More

J Pak Med Assoc 2019 Feb;69(Suppl 1)(1):S12-S16

Nevill Hall Hospital, Brecon Road, Abergavenny NP7 7EG.

Objective: To compare the accuracy of Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) and modified Alvarado scores with that of non-contrast computed tomography scan and ultrasound of abdomen and pelvis.

Methods: The observational correlational study was conducted at Manipal Hospital, Bengaluru, India, from April 1, 2014, to April 30, 2016, and comprised patients aged 18-60 years presenting with right lower quadrant pain to the emergency department. Modified Alvarado, RIPASA scores and ultrasound of abdomen and pelvis with optional non-contrast computed tomography scan reports were collected. Read More

Surg Obes Relat Dis 2019 Jan 11. Epub 2019 Jan 11.

Department of Surgery, Queen's University, Kingston, Ontario, Canada. Electronic address:

Background: An incidental finding of intestinal nonrotation at the time of bariatric surgery poses the following 2 dilemmas: (1) which operation to perform, and (2) whether an appendectomy should be performed concurrently.

Objectives: To review the experience of 2 Bariatric Centers of Excellence with laparoscopic sleeve gastrectomy (LSG) in patients with intestinal nonrotation, and to perform a systematic review of the literature on this topic.

Setting: Two Bariatric Centers of Excellence as designated by the Ontario Bariatric Network. Read More

Int J Surg Case Rep 2019 29;55:103-106. Epub 2019 Jan 29.

Department of Gastroenterological Surgery, Hiroshima City Asa Citizens Hospital, Japan.

Introduction: Perforating appendicitis and abscess-forming appendicitis may cause septic disseminated intravascular coagulation (DIC). However, non-perforating acute appendicitis with septic DIC is extremely rare.

Presentation Of Case: A 67-year-old man was referred to our hospital one day after starting oral antibiotic treatment for acute appendicitis. Read More

Eur J Trauma Emerg Surg 2019 Feb 2. Epub 2019 Feb 2.

Department of General Surgery, Kishiwada Tokushukai Hospital, 4-27-1 Kamoricho, Kishiwada, Osaka, 596-0042, Japan.

Background: Appendectomy is one of the most common operations. Laparoscopic appendectomy (LA) is considered first-line treatment, but the use of LA for treatment of complicated appendicitis remains controversial. Here, we performed a retrospective analysis to compare clinical outcomes between patients treated with LA and those who underwent open appendectomy (OA). Read More

Zhonghua Wei Chang Wai Ke Za Zhi 2019 Jan;22(1):49-58

Department of General Surgery, Medical School of Nanjing University, Jinling Hospital, Jiangsu Nanjing 210002,

Objective: To analyze the current status of diagnosis and management of acute appendicitis (AA) in China.

Methods: Questionnaire survey was used to retrospectively collect data of hospitalized patients with AA from 43 medical centers nationwide in 2017 (Sort by number of cases provided: Jinling Hospital of Medical School of Nanjing University, The First Affiliated Hospital of Xinjiang Medical University, Lu'an People's Hospital, Tengzhou Central People's Hospital, Dalian Central Hospital, The Affiliated Hospital of Xuzhou Medical University, Dongying People's Hospital, Jinjiang Hospital of Traditional Chinese Medicine, Huangshan Shoukang Hospital, Xuyi People's Hospital, Nanjing Jiangbei People's Hospital, Lanzhou 940th Hospital of PLA, Heze Municipal Hospital, The First College of Clinical Medical Science of China Three Gorges University, Affiliated Jiujiang Hospital of Nanchang University, The Second People's Hospital of Hefei, Affiliated Central Hospital of Shandong Zaozhuang Mining Group, The Third People's Hospital of Kunshan City, Xuzhou First People's Hospital, The 81st Group Army Hospital of PLA, Linyi Central Hospital, The General Hospital of Huainan Eastern Hospital Group, The 908th Hospital of PLA, Liyang People's Hospital, The 901th Hospital of Joint Logistic Support Force, The Third Affiliated Hospital of Chongqing Medical University, The Fourth Hospital of Jilin University, Harbin Acheng District People's Hospital, The First Affiliated Hospital of Zhengzhou University, Nanjing Luhe People's Hospital, Taixing Municipal People's Hospital, Baotou Central Hospital, The Affiliated Hospital of Nantong University, Linyi People's Hospital, The 72st Group Army Hospital of PLA, Zaozhuang Municipal Hospital, People's Hospital of Dayu County, Taixing City Hospital of Traditional Chinese Medicine, Suzhou Municipal Hospital, Beijing Guang'anmen Hospital, Langxi County Hospital of Traditional Chinese Medicine, Nanyang Central Hospital, The Affiliated People's Hospital of Inner Mongolia Medical University).The diagnosis and management of AA were analyzed through unified summary. Read More

Medicine (Baltimore) 2019 Feb;98(5):e14104

Department of Surgery, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, South Korea.

Rationale: The horseshoe anomaly of the vermiform appendix is extremely rare. Preoperative confirmation of this anomaly is difficult; therefore, routine procedures, such as appendectomy, may become unexpectedly challenging when such anomalies are encountered during the surgical process.

Patient Concerns: A 33-year-old man presented with abdominal pain in the right lower abdomen owing to acute appendicitis confirmed via computed tomography. Read More

J Pak Med Assoc 2019 Feb;69(Suppl 1)(1):S12-S16

Nevill Hall Hospital, Brecon Road, Abergavenny NP7 7EG.

Objective: To compare the accuracy of Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) and modified Alvarado scores with that of non-contrast computed tomography scan and ultrasound of abdomen and pelvis.

Methods: The observational correlational study was conducted at Manipal Hospital, Bengaluru, India, from April 1, 2014, to April 30, 2016, and comprised patients aged 18-60 years presenting with right lower quadrant pain to the emergency department. Modified Alvarado, RIPASA scores and ultrasound of abdomen and pelvis with optional non-contrast computed tomography scan reports were collected. Read More

J Surg Res 2019 Apr 13;236:110-118. Epub 2018 Dec 13.

Department of Surgery, University of California San Diego, La Jolla, California.

Background: Surgical supplies occupy a large portion of health care expenditures but is often under the surgeon's control. We sought to assess whether an automated, surgeon-directed, cost feedback system can decrease supply expenditures for five common general surgery procedures.

Materials And Methods: An automated "surgical receipt" detailing intraoperative supply costs was generated and emailed to surgeons after each case. Read More

Gan To Kagaku Ryoho 2018 Dec;45(13):1848-1850

Dept. of Surgery, Sumitomo Hospital.

A 40-year-old woman was admitted to our hospital with the chief complaint of miction pain. MRI showed fundal wall thickening of the bladder in contact with the appendix. Under cystoscopy, redness of the mucous membrane was found in the posterior wall of the bladder. Read More

J Surg Res 2019 Mar 16;235:404-409. Epub 2018 Nov 16.

Department of Surgery, Yale University School of Medicine, New Haven, Connecticut.

Background: Adolescents who use prescription opioids have an increased risk for future drug abuse and overdose, making them a high-risk population. Appendectomy is one of the most common surgical procedures in this age group, often requires opioid analgesia, and is performed by both pediatric and general surgeons. Prescription patterns comparing these two provider groups have not yet been evaluated; we hypothesize that general surgery providers prescribe more opioids for adolescent and young adult patients than do pediatric surgery providers. Read More

J Surg Res 2019 Mar 1;235:237-243. Epub 2018 Nov 1.

Department of Surgery, Johns Hopkins University, Baltimore, Maryland. Electronic address:

Background: Acute appendicitis is currently one of the most common surgical emergencies. Intra-abdominal abscesses (IAA) are a fearsome complication, which may occur. Irrigation during the appendectomy is one of the factors suggested to affect the rates of IAA. Read More

J Surg Res 2019 Mar 31;235:223-226. Epub 2018 Oct 31.

Department of General Surgery, TC Thompson Children's Hospital, University of Tennessee Health Science Center, Chattanooga, Tennessee.

Background: Single-incision laparoscopic appendectomy (SILA) in the pediatric population has been well described. Our children's hospital has adopted this modality for nearly all appendectomies. From our center's experience, we hoped to identify factors that portend conversion from SILA to multiport appendectomy. Read More

Trauma Surg Acute Care Open 2018 30;3(1):e000222. Epub 2018 Dec 30.

Department of Surgery, Acute Care Surgery, College of Medicine, University of Kentucky, Lexington, Kentucky, USA.

Background: Laparoscopic appendectomy can be performed on a fast-track, short-stay, or outpatient basis with high success rates, low morbidity, low readmission rates, and shorter length of hospital stay. Cost savings from outpatient appendectomy have not been well described. We hypothesize that outpatient laparoscopic appendectomy is associated with cost savings. Read More

Gynecol Obstet Fertil Senol 2019 02 25;47(2):168-179. Epub 2019 Jan 25.

Clinique de gynécologie, hôpital Jeanne-de-Flandre, centre hospitalier régional universitaire de Lille, 1, rue Eugène-Avinée, 59000 Lille, France.

Early stage ovarian epithelial cancer (stage I according to the FIGO classification, i.e. limited to ovaries) affects 20% to 33% of patients with ovarian cancer. Read More

Gynecol Obstet Fertil Senol 2019 02 24;47(2):100-110. Epub 2019 Jan 24.

Service de gynécologie-obstétrique et médecine de la reproduction, hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France; UMRS-938, institut universitaire de cancérologie Sorbonne université, 75000 Paris, France.

Faced to an undetermined ovarian mass on ultrasound, an MRI is recommended and the ROMA score (combining CA125 and HE4) can be proposed (grade A). In case of suspected early stage ovarian or fallopian tube cancer, omentectomy (at least infracolonic), appendectomy, multiple peritoneal biopsies, peritoneal cytology (grade C) and pelvic and para-aortic lymphadenectomy are recommended (grade B) for all histological types, except for the expansive mucinous subtype where lymphadenectomy may be omitted (grade C). Minimally invasive surgery is recommended for early stage ovarian cancer, if there is no risk of tumor rupture (grade B). Read More

Visc Med 2018 Dec 24;34(6):453-458. Epub 2018 Nov 24.

Medizinische Klinik II, Diakonissenkrankenhaus Mannheim, Mannheim, Germany.

Background: Ever since the first appendectomy has been performed, surgery has been the standard of care for acute appendicitis, with antibiotic therapy being reserved for special situations. Recent studies have shown the feasibility of antibiotic therapy for uncomplicated appendicitis.

Methods: This clinical therapeutic review is based both on author expertise and a selective literature survey in PubMed based on the term 'appendicitis', combined with the terms 'acute', 'complicated', 'conservative', 'non-operative', 'therapy', 'surgery', and 'strategy'. Read More

J Gastrointest Surg 2019 Jan 22. Epub 2019 Jan 22.

Department of Trauma, Critical Care, and General Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55901, USA.

Background: We evaluated whether TAP blocks performed at the time of appendectomy resulted in reduced total oral morphine equivalent (OME) prescribed and fewer 30-day opioid prescription (OP) refills.

Study Design: Single institution review of historical data (2010-2016) was performed. Adults (≥ 18 years) that underwent appendectomy for appendicitis with uniform disease severity (AAST EGS grades I, II) were included. Read More

Am J Case Rep 2019 Jan 19;20:78-82. Epub 2019 Jan 19.

Department of Surgery, Beirut General Hospital, Beirut, Lebanon.

BACKGROUND Left-sided acute appendicitis, although well described in the literature, is still an easily missed diagnosis. Midgut malrotation and situs inversus are 2 known leading conditions that contribute to misdiagnosis of appendicitis. CASE REPORT Here is the case of a 27-year-old male without any previous medical history, who presented with left lower quadrant tenderness and was misdiagnosed with gastroenteritis as an outpatient and sent home; the patient presented the next day to the emergency department where he was found to have acute appendicitis with situs inversus. Read More

Medicina (Kaunas) 2019 Jan 4;55(1). Epub 2019 Jan 4.

Division of Surgery, Fujinomiya City General Hospital, Nishiki-cho, Fujinomiya, Shizuoka 4180076, Japan.

: In patients with acute appendicitis (AA), preoperative computed tomography (CT) findings suggesting development of intraabdominal abscess (IAA) had not been widely used. The aim of this study was to investigate the preoperative clinical and radiological factors that predict the development of a postoperative IAA in patients with AA who were treated by laparoscopic appendectomy (LA). : Two hundred and sixteen patients with pathologically proven AA underwent LA between January 2013 and March 2018 in our department. Read More

World J Clin Cases 2018 Dec;6(16):1175-1181

Department of Surgery, St George Public Hospital, Kogarah NSW 2217, Australia.

Background: Appendicitis, the inflammation of the appendix, is the most common abdominal surgical emergency requiring expedient surgical intervention. Extended-spectrum beta-lactamases (ESBLs) are bacterial enzymes that catalyse the degradation of the beta-lactam ring of penicillins and cephalosporins (but without carbapenemase activity), leading to resistance of these bacteria to beta-lactam antibiotics. Recent increases in incidence of ESBL-producing bacteria have caused alarm worldwide. Read More

JSLS 2018 Oct-Dec;22(4)

General Surgery Department, Siedlce Hospital, Siedlce, Poland.

Background And Objectives: Although laparoscopic appendectomy (LA) has been used for 35 years, the open approach (OA) is preferred worldwide. Widespread access to instrumentation in a number of centers has reduced economic and logistical obstacles. The aim of this work is to compare the results for patients with suspected appendicitis treated using an OA versus patients treated using LA. Read More

Am Surg 2018 Dec;84(12):e519-e521

Am Surg 2018 Dec;84(12):1951-1956

Noise can exert undeniable pressure on human minds, especially during tasks that require high precision and attention, such as those performed during surgery. To investigate whether auditory stimuli increases mental loads during laparoscopic surgery, we examined the effects of operating room (OR) noises and music by measuring mean changes in pupil sizes and subjectively assessing performances during surgery. We recruited 24 subjects with varying laparoscopic surgery experience levels to perform complete appendectomy using a laparoscopic simulator. Read More

Surg Endosc 2019 Jan 2. Epub 2019 Jan 2.

Department of Surgery, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.

Background: Presently, there is equipoise regarding the surgical technique used to manage the appendiceal stump during laparoscopic appendectomy. The purpose of this research was to determine whether the routine use of loop ligature, compared to stapling, is cost effective from a hospital payer perspective.

Methods: A retrospective cohort study was conducted amongst patients undergoing emergency laparoscopic surgery for acute appendicitis at two major academic hospitals. Read More

Ann Surg 2018 Dec 22. Epub 2018 Dec 22.

Department of Surgery, Boston Children's Hospital, Boston, MA.

Objective: To describe variability in and consequences of opioid prescriptions following pediatric laparoscopic appendectomy.

Summary Background Data: Postoperative opioid prescribing patterns may contribute to persistent opioid use in both adults and children.

Methods: We included children <18 years enrolled as dependents in the Military Health System Data Repository who underwent uncomplicated laparoscopic appendectomy (2006-2014). Read More

Surgery 2018 Dec 24. Epub 2018 Dec 24.

Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA. Electronic address:

Background: Appendectomy is the most commonly performed emergency operation in the United States, with approximately 370,000 patients undergoing the procedure every year. Although laparoscopic appendectomy is associated with decreased complications when compared with open appendectomy, the risk for infectious complications, including surgical site infection, intra-abdominal abscess, and sepsis, remains a significant source of postoperative morbidity and health care cost. The goal of this study is to determine whether the appendix retrieval technique during laparoscopic appendectomy affects risk of infectious complications. Read More

Zhonghua Wei Chang Wai Ke Za Zhi 2018 Dec;21(12):1433-1438

PLA Institute of General Surgery, Jinling Hospital, Nanjing University, Nanjing 210002, China, Email:

Objective: To systematically evaluate the safety and efficacy of laparoscopic surgery versus conservative treatment for appendiceal abscess.

Methods: The databases of CNKI, Wangfang, VIP, PubMed, EMBASE and Cochrane Library were searched to retrieve randomized controlled trials (RCT) or clinical controlled trials (CCT) comparing laparoscopic surgery with conservative treatment for appendiceal abscess published before June 2018. The search terms were Chinese or English. Read More

Zhonghua Wei Chang Wai Ke Za Zhi 2018 Dec;21(12):1374-1379

Research Institute of General Surgery, General Hospital of Nanjing Military Command, Nanjing 210002,China,

Objective: To explore the high risk factors of adult complex appendicitis, and to provide a reference for the development of a reasonable treatment strategy for acute appendicitis.

Methods: A retrospective case-control study was conducted to collect clinical data of 312 adult patients with acute appendicitis confirmed by pathology undergoing appendectomy, including open and laparoscopic surgery, from May 2011 to August 2016 at Affiliated Hospital of Qingdao University. Age <14 years old, pregnant women, complicating abscess around the appendix, AIDS, blood system diseases, autoimmune diseases, inflammatory bowel disease or progressive cancer patients were excluded. Read More

J Laparoendosc Adv Surg Tech A 2019 Feb 26;29(2):184-191. Epub 2018 Dec 26.

3 Department of Surgery, Valladolid University , Valladolid, Spain .

Purpose: Acute appendicitis (AA) is the most frequent surgical entity in the emergency department, but its correct diagnosis remains challenging. To improve diagnosis, clinical prediction rules (CPRs) have been created to establish objective scores for the probability of suffering AA. In this study, we establish scores indicating whether laparoscopy would be superior to clinical observation or repeat diagnostic test. Read More

Am J Surg 2018 Dec 15. Epub 2018 Dec 15.

Department of Surgery, McMaster University, Hamilton, Ontario, Canada; Division of General Surgery, St. Joseph's Healthcare, Hamilton, Ontario, Canada. Electronic address:

Background: The purpose of this study was to examine factors affecting morbidity and cost after pediatric appendectomy and particularly the role of adult surgical volume.

Materials And Methods: This was population-based study including all pediatric patients who underwent appendectomy for appendicitis in Canada (excluding Quebec) from 2008 to 2015. All-cause morbidity was the main outcome of interest. Read More

Pan Afr Med J 2018 16;30:212. Epub 2018 Jul 16.

Department of General and Digestive Surgery Farhat Hached Universitary Hospital, Sousse, Tunisia.

The occurrence of acute appendicitis during pregnancy may pose diagnostic and therapeutic difficulties. In fact pregnancy can make the clinical diagnosis delicate and the use of morphological examinations is still subject to controversy. The debates concerning the ideal surgical approach during pregnancy continue. Read More

Ann Ital Chir 2018 ;89:448-454

Aim: The purpose of this study was to compare cosmetic, along with surgical, results between single incision laparoscopic appendectomy (SILA) and conventional laparoscopic appendectomy (CLA), particularly from patients' points of view.

Materials And Methods: All of the patients who underwent surgery for suspected acute appendicitis and were eligible for laparoscopic surgery were evaluated prospectively in our center between June 2013 and January 2015. Patients were underwent CLA or SILA were compared for operative results and cosmetic outcomes by Body Image Questionnaire. Read More