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J Am Coll Surg 2019 Mar 14. Epub 2019 Mar 14.

Department of Surgery, Saint Joseph Mercy Oakland, Pontiac, MI.

Background: We sought to evaluate change in postoperative prescription practices in an independent community-based hospital following hospital interventions and a state legislation change.

Study Design: This is a retrospective review of opioid naïve adult subjects who underwent five common general surgical procedures between 2015-2017, including: cholecystectomy, appendectomy, minimally invasive inguinal hernia repair, open inguinal hernia repair, and breast lumpectomy. Educational interventions were introduced, new statewide legislation was passed, and 129 subsequent cases were reviewed. Read More

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

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

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

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

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

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

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

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

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

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

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

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

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):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

Dan Med J 2019 Jan;66(1)

Introduction: Emergency laparotomy is a high-risk procedure associated with severe post-operative morbidity and high mortality. The aim was to conduct a nationwide cohort consisting of all patients undergoing emergency laparotomy during an 11-year period and to examine both short- and long-term outcomes.

Methods: Adult patients treated with emergency laparotomy due to gastrointestinal conditions from 2003 through 2013 were identified in the Danish National Patient Register. Read More

Medwave 2018 Dec 11;18(8):e7370. Epub 2018 Dec 11.

Proyecto Epistemonikos, Santiago, Chile; Centro Evidencia UC, Pontificia Universidad Católica de Chile, Santiago, Chile; Departamento de Medicina Interna, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile. Email: Address: Centro Evidencia UC, Pontificia Universidad Católica de Chile, Diagonal Paraguay 476, Santiago, Chile.

Introduction: The treatment of acute appendicitis using laparoscopy reduces the risk of wound infection, hospitalization time and return to normal activity. However, it increases the risk of intra-abdominal abscess, which is one the main complications of complicated appendicitis.

Methods: We searched in Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. Read More

J Trauma Acute Care Surg 2019 Mar;86(3):479-488

From the Section of General Surgery, Trauma, and Surgical Critical Care, Department of Surgery (B.J.S., K.A.D., K.M.S.), Yale School of Medicine, New Haven, Connecticut.

Background: The impact of human immunodeficiency virus (HIV) infection on outcomes following common emergency general surgery procedures has not been evaluated since the widespread introduction of highly active antiretroviral therapy.

Methods: A retrospective cohort study was conducted using the Nationwide Inpatient Sample. Records of patients who underwent laparoscopic or open appendectomy, cholecystectomy, or colon resection after emergency admission from 2004 to 2011 were obtained. Read More

Surg Infect (Larchmt) 2018 Dec 11. Epub 2018 Dec 11.

1 Cardinal Glennon Children's Medical Center , St. Louis, Missouri.

Background: No consensus exists regarding duration of antibiotic therapy for complicated appendicitis treated with interval appendectomy. We hypothesized that more than two weeks of antibiotic therapy does not decrease complication rates in asymptomatic patients.

Patients And Methods: A retrospective review of all patients with complicated appendicitis treated with interval appendectomy from 2010-2015 was performed. Read More

Ann Med Surg (Lond) 2018 Dec 9;36:168-172. Epub 2018 Nov 9.

UCL Medical School, UCL, Research Department of Medical Education, Room GF/664, Royal Free Campus, Hampstead, London, NW3 2PR, UK.

Background: Appendicitis is a medical condition that causes painful inflammation of the appendix. For acute appendicitis, appendectomy is immediately required as any delay may lead to serious complications such as gangrenous or perforated appendicitis with or without localized abscess formation. Patients who had appendectomy for complicated appendicitis are more prone to develop post-operative complications such as peritoneal abscess or wound infection. Read More

J Trauma Acute Care Surg 2018 Dec 3. Epub 2018 Dec 3.

Professor of Medicine and Emergency Medicine, Department of Emergency Medicine (and Department of Medicine, Division of Infectious Diseases), Olive View-UCLA Medical Center, 14445 Olive View Drive, North Annex, Sylmar, CA 91342.

Background: Meta-analyses and a recent guideline acknowledge that conservative management of uncomplicated appendicitis with antibiotics can be successful for patients who wish to avoid surgery. However, guidance as to specific management does not exist.

Methods: PUBMED and EMBASE search of trials describing methods of conservative treatment was conducted according to PRISMA guidelines. Read More

Ulus Travma Acil Cerrahi Derg 2018 Nov;24(6):552-556

Department of General Surgery, İstanbul University İstanbul Faculty of Medicine, İstanbul-Turkey.

Background: The aim of this study was to compare the obstetric and surgical outcomes of laparoscopic appendectomy (LA) and open appendectomy (OA) performed for pregnant women at a single center. It was the hypothesis of this study that there would be no significant difference in the results.

Methods: The medical records of 57 consecutive pregnant women who underwent an appendectomy between January 2009 and September 2018 were reviewed retrospectively. Read More

Ann Surg 2018 Nov 29. Epub 2018 Nov 29.

Department of Surgery, Massachusetts General Hospital, Boston, MA.

Objective: The objective of this study was to determine the effects of open versus laparoscopic surgery on the development of adhesive small bowel obstruction (aSBO).

Summary Background Data: aSBO is a significant contributor to short and long-term postoperative morbidity. Laparoscopy has demonstrated a protective effect in colorectal surgery, but these effects have not been generalized to other abdominal procedures. Read More

Cochrane Database Syst Rev 2018 11 28;11:CD001546. Epub 2018 Nov 28.

Institute for Research in Operative Medicine (IFOM) - Department for Evidence-based Health Services Research, University Witten/Herdecke, Ostmerheimer Str. 200 (Building 38), Cologne, Germany, 51109.

Background: The removal of the acute appendix is one of the most frequently performed surgical procedures. Open surgery associated with therapeutic efficacy has been the treatment of choice for acute appendicitis. However, in consequence of the evolution of endoscopic surgery, the operation can also be performed with minimally invasive surgery. Read More

J Surg Res 2018 Dec 8;232:587-594. Epub 2018 Aug 8.

Department of Surgery, University of Virginia, Charlottesville, Virginia.

Background: In North America, the prevalence of gastroesophageal reflux disorder ranges from 18.1% to 27.8%. Read More

J Surg Res 2018 Dec 30;232:33-38. Epub 2018 Jun 30.

Heart Center, Turku University Hospital, Turku, Finland; Research Center of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.

Background: We aimed to investigate the trends in occurrence and the treatment approaches of appendicitis in Finnish children.

Material And Methods: All patients aged <16 y hospitalized for appendicitis in Finland in 2004-2014 were included. Data were retrospectively collected from the Finnish Care Register for Health Care and Statistics Finland. Read More

Rev Col Bras Cir 2018 Nov 14;45(5):e19. Epub 2018 Nov 14.

Universidade Federal de Pelotas, Faculdade de Medicina, Pelotas, RS, Brasil.

Objective: to evaluate the main risk factors for postoperative complications in patients undergoing appendectomy for acute appendicitis.

Methods: we retrospectively analyzed 1241 patients undergoing open or laparoscopic appendectomy. Patients were allocated to four groups: Group 1, without postoperative complications, and Groups 2, 3, and 4, with postoperative complications defined according to their severity, following Clavien-Dindo classification (I, II, and ≥III, respectively). Read More

Adv Ther 2018 Dec 13;35(12):2176-2185. Epub 2018 Nov 13.

Department of Surgery, National Children's Medical Center, Beijing Children's Hospital Affiliated to Capital Medical University, Beijing, 100045, China.

Introduction: This study aims to compare the clinical effects of an incision skin tissue retractor for mini-incision open appendectomy and laparoscopic surgery for pediatric appendicitis.

Methods: From January 2014 to July 2017, a total of 248 patients were included in the present study. Laparoscopic appendectomy was performed for 108 cases (LA group), and mini-incision open appendectomy with an incision skin tissue retractor was performed for 140 cases (MOA-ISTR group). Read More

Chirurg 2019 Mar;90(3):186-193

Klinik für Allgemein‑, Viszeral‑, Thorax- und Gefäßchirurgie, Klinikum Südstadt, Südring 81, 18059, Rostock, Deutschland.

The treatment of choice in acute appendicitis is still the surgical removal of an inflamed vermiform appendix. There is still some disagreement regarding the optimal access route, i.e. Read More

Surg Laparosc Endosc Percutan Tech 2018 Nov 1. Epub 2018 Nov 1.

Department of Pediatric Surgery, Izmir Katip Celebi University, Cigli.

Purpose: Laparoscopic appendectomy has become more popular compared with the open appendectomy in children, but there are limited data on the effects of pneumoperitoneum and Trendelenburg position on cerebral oxygenation. This study was designed to evaluate the changes in cerebral saturation using near-infrared spectroscope during laparoscopic surgery in children.

Methods: The children underwent laparoscopic (LAP Group, n=22) or open appendectomy (OPEN Group, n=22). Read More

Ulus Travma Acil Cerrahi Derg 2018 Sep;24(5):429-433

Department of General Surgery, Başkent University Faculty of Medicine, Ankara-Turkey.

Background: In this study, we aimed to investigate the factors causing conversion from laparoscopic appendectomy (LA) to open appendectomy (OA) in patients with acute appendicitis and to investigate the role of preoperative C reactive protein (CRP) and neutrophil ratio in this conversion and determine a cut-off point for these parameters.

Methods: Records of patients who underwent LA due to acute appendicitis at our general surgery department between January 2011 and January 2017 were retrospectively evaluated. The preoperative American Society of Anesthesiology (ASA) scores, Alvarado scores, white blood cell count, C-reactive protein level, and neutrophil ratio were evaluated. Read More

Surgery 2019 Mar 29;165(3):593-601. Epub 2018 Oct 29.

Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA; Department of Surgery, Veterans Affairs Greater Los Angeles Healthcare System, CA.

Background: Epidemiologic data related to the surgical management of appendicitis are out of date. As we contemplate the role of nonoperative therapy in uncomplicated appendicitis, a contemporary profile of the risks and benefits of operative appendectomy is needed.

Methods: This study merged the 2016 National Surgical Quality Improvement Program essential and appendectomy-targeted participant use files. Read More

Langenbecks Arch Surg 2018 Nov 20;403(7):805-810. Epub 2018 Oct 20.

Department of Social Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.

Purpose: We aimed to introduce a new surgical method for open appendectomy including a right groin incision with adipocutaneous flap and to compare its feasibility, safety, and cosmetic outcomes with classic McBurney's incision.

Methods: Patients with the diagnosis of acute appendicitis who were candidates for appendectomy surgery at General Surgery Department, Besat Hospital, Hamadan University of Medical Sciences, Iran, in 2016 and 2017, were enrolled in a randomized controlled clinical study. Patients were randomly assigned to two groups each containing 50 patients. Read More

J Trauma Acute Care Surg 2019 Jan;86(1):36-42

From the Division of Acute Care Surgery, Department of Surgery (S.S., M.R., E.H.N., E.L., K.G.I., J.L., P.T.), North Estonia Medical Centre, Tallinn; School of Medicine, University of Tartu (S.S., V.M., A.L., U.L., P.T.), Tartu, Estonia; and Division of Trauma, Hand and Reconstructive Surgery (T.L.), Goethe University Hospital, Frankfurt/Main, Germany.

Background: Recent investigations noted noninferiority in short-course antimicrobial treatments following source control in abdominal infections. We set out to investigate noninferiority of a short and fixed (24 hours) antibiotic administration compared to extended treatment after source control in complicated appendicitis in a prospective single-center open-label randomized controlled trial.

Methods: After Institutional Review Board (IRB) approval, all consecutive adult patients (age, ≥ 18 years) with complicated appendicitis including gangrenous appendicitis, perforated appendicitis, and appendicitis with periappendicular abscess between May 2016 and February 2018 were randomly allocated to antibacterial therapy limited to 24 hours (short) vs. Read More

J Surg Res 2018 Nov 21;231:186-194. Epub 2018 Jun 21.

Department of Surgery, Nationwide Children's Hospital, Columbus, Ohio; Center for Surgical Outcomes Research, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio. Electronic address:

Background: The objective of this study was to identify ranges of postoperative length of stay (LOS) for common pediatric procedures using a large multi-institutional database.

Materials And Methods: A retrospective analysis of the most frequently performed general surgical procedures in the ACS-NSQIP Pediatric (2013-2015) was performed. These included laparoscopic appendectomy (LA), laparoscopic cholecystectomy, laparoscopic gastrostomy, laparoscopic esophagogastric fundoplication (LF), thoracoscopic repair of pectus excavatum (TPE), open appendectomy (OA), enterostomy closure (OEC), gastrostomy closure (OGC), and bowel resection (OBR). Read More

Can J Surg 2018 12;61(6):412-417

From the Department of Surgery, Kingston Health Sciences Centre, Kingston, Ont. (Patel, Nanji, Brogly, Merchant); the Faculty of Health Sciences, Queen's University, Kingston, Ont. (Patel, Nanji, Merchant); the Institute for Clinical Evaluative Sciences, Queen's University, Kingston, Ont. (Lajkosz, Groome); and the Department of Public Health Sciences, Queen's University, Kingston, Ont. (Groome).

Background: Appendectomy is a common emergency procedure. The risks have been reported in previous studies but often are limited to inpatient complications. The purpose of this study was to describe inpatient and outpatient rates of complications associated with appendectomy in a contemporary population-based cohort and explore factors associated with these complications. Read More

JAMA 2018 09;320(12):1259-1265

Division of Digestive Surgery and Urology, Department of Digestive Surgery, Turku University Hospital, University of Turku, Turku, Finland.

Importance: Short-term results support antibiotics as an alternative to surgery for treating uncomplicated acute appendicitis, but long-term outcomes are not known.

Objective: To determine the late recurrence rate of appendicitis after antibiotic therapy for the treatment of uncomplicated acute appendicitis.

Design, Setting, And Participants: Five-year observational follow-up of patients in the Appendicitis Acuta (APPAC) multicenter randomized clinical trial comparing appendectomy with antibiotic therapy, in which 530 patients aged 18 to 60 years with computed tomography-confirmed uncomplicated acute appendicitis were randomized to undergo an appendectomy (n = 273) or receive antibiotic therapy (n = 257). Read More

J Surg Educ 2019 Mar - Apr;76(2):506-511. Epub 2018 Sep 21.

Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas; Department of Surgery, VA North Texas Health Care System, Dallas, Texas. Electronic address:

Introduction: An open appendectomy used to be one of the most common cases performed by interns and physical exam dictated operative intervention. We hypothesized that the management of acute appendicitis has drastically changed from these previous practices.

Methods: A retrospective, single institution study was performed at the VA North Texas Health Care System between July 2005 to June 2017 for all patients who underwent an appendectomy. Read More

Surg Clin North Am 2018 Oct 13;98(5):1005-1023. Epub 2018 Jul 13.

Department of Translational Science, Creighton University School of Medicine, Uniformed Services University of the Health Sciences, F. Edward Hébert School of Medicine, Walter Reed National Military Medical Center, Bethesda, MD, USA.

The treatment of appendicitis has evolved since the first appendectomy in the eighteenth century. It seems to have come full circle with nonoperative management in the era before frequent surgical interventions, to open surgical interventions, minimally invasive interventions, and now back to a renewed interest in nonoperative management of acute appendicitis. Scoring systems to help refine the diagnosis of acute appendicitis and advances in medical imaging have also changed the management of this condition. Read More

Am Fam Physician 2018 Jul;98(1):25-33

Saint Louis University Southwest Illinois Family Medicine Residency, Belleville, IL, USA.

Appendicitis is one of the most common causes of acute abdominal pain in adults and children, with a lifetime risk of 8.6% in males and 6.7% in females. Read More

Endosc Int Open 2018 Sep 11;6(9):E1112-E1119. Epub 2018 Sep 11.

Department of Gastroenterology & Hepatology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.

 Colorectal polyps involving the appendiceal orifice (AO) are difficult to resect with conventional polypectomy techniques and therefore often require surgical intervention. These appendiceal polyps could potentially be removed with endoscopic full-thickness resection (eFTR) performed with a full-thickness resection device (FTRD). The aim of this prospective observational case study was to evaluate feasibility, technical success and safety of eFTR procedures involving the AO. Read More

BMJ Open 2018 Aug 30;8(8):e020101. Epub 2018 Aug 30.

Department of Epidemiology and Public Health, Centre Pasteur of Cameroon, Yaoundé, Cameroon.

Introduction: Acute appendicitis is a surgical emergency and the most frequent aetiology of acute surgical abdominal pain in developed countries. Universally, its widely approved treatment is appendectomy. Like all surgical procedures, appendectomy can be associated with many complications among which are surgical site infections (SSIs). Read More

Rev Med Chil 2018 May;146(5):660-664

Departamento de Cirugía Digestiva, Hospital Clínico, Pontificia Universidad Católica de Chile, Santiago, Chile.

Garengeot's hernia corresponds to the presence of the appendix within a femoral hernia, associated or not with acute appendicitis. The diagnosis of this uncommon situation is usually done during surgery. Furthermore, the clinical presentation as necrotizing fasciitis is a rare condition. Read More

World J Surg 2019 01;43(1):67-74

Departamento de Cirugía, Facultad de Medicina, Universidad Nacional de Colombia, Carrera 45 N° 26-85, Edificio 471, Bogotá, Colombia.

Background: Although many studies have compared outcomes of laparoscopic appendectomy (LA) and open appendectomy (OA), some clinical and economic outcomes continue to be controversial, particularly in low-medium-income countries. We aimed at determining clinical and economic outcomes associated with LA versus OA in adult patients in Colombia.

Methods: Retrospective, cohort study based on administrative healthcare records included all patients who underwent LA or OA in Colombia's contributory regime between July 1, 2013, and September 30, 2015. Read More

Ann Surg 2018 Oct;268(4):700-707

Department of Surgery, University of Michigan, Ann Arbor, MI.

Background: Telemedicine in surgery holds promise for improving access and decreasing costs, but its role remains ill-defined. This pilot study was performed to investigate the safety, feasibility, and financial implications of providing postoperative care using an electronic clinic (eClinic) at a university hospital.

Methods: An easy-to-use and secure eClinic platform was constructed in Epic (Epic Systems Corporation, Verona, WA). Read More

Adv Clin Exp Med 2018 Nov;27(11):1529-1534

Department of Pediatric Surgery, Medical University of Bialystok, Poland.

Background: Cathepsin B (CatB) belongs to a family of lysosomal cysteine proteases and plays an important role in intracellular proteolysis.

Objectives: The concentration of CatB and 20S proteasome was evaluated in the serum of children with appendicitis, before and after surgery, on a basis of an innovative method for determining biomolecules concentration - surface plasmon resonance imaging (SPRI) biosensor.

Material And Methods: Forty-two children with acute appendicitis, who were treated at the Department of Pediatric Surgery (Medical University of Bialystok, Poland), were randomly included into the study (age: 5-17 years, mean age: 11. Read More

Surg Laparosc Endosc Percutan Tech 2018 Oct;28(5):314-317

Department of Pediatric Surgery, Huai'an Women and Children's Hospital, Jiangsu, P.R. China.

Purpose: Idiopathic intussusception is one of the most common causes of small bowel obstruction in children. To decrease subsequent recurrence and to detect a lead point, an early laparoscopy was performed for children with multiple recurrent ileocolic intussusception.

Materials And Methods: Between January 2014 and July 2017, a total of 2561 consecutive children with intussusception were treated and followed. Read More

World J Surg 2018 Dec;42(12):3903-3910

Department of General Surgery, Maggiore Hospital, Parma, Italy.

Background: Our aim is to compare the management approaches and clinical outcomes of acute appendicitis according to annual Gross National Income per Capita (GNI/Capita) of countries.

Methods: Consecutive patients who were diagnosed to have acute appendicitis from 116 centers of 44 countries were prospectively studied over a 6-month period (April-September 2016). Studied variables included demography, Alvarado score, comorbidities, radiological and surgical management, histopathology, and clinical outcome. Read More