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[Acute appendicitis - changes in epidemiology, diagnosis and therapy]
1DRK Kliniken Berlin|Köpenick, Klinik für Chirurgie, Berlin, Deutschland. m.sahm@drk-kliniken-berlin.de
Zentralblatt Fur Chirurgie
|December 25, 2010
Summary
Appendicitis incidence is decreasing, but perforated cases remain constant despite advanced diagnostics. Laparoscopic appendectomy is now standard, with staplers commonly used for stump closure.
Area of Science:
- Gastroenterology
- Surgical Innovation
- Epidemiology
Background:
- Appendicitis is a leading cause of acute abdomen, with approximately 135,000 appendectomies performed annually in Germany.
- Recent trends show a decline in acute non-perforated appendicitis incidence.
- Perforated appendicitis rates have not decreased despite advancements in diagnostic imaging and surgical techniques.
Purpose of the Study:
- To analyze current trends in appendicitis epidemiology, diagnosis, and therapy.
- To evaluate the impact of imaging diagnostics and laparoscopic surgery on appendicitis outcomes.
- To assess changes in surgical techniques for appendectomy.
Main Methods:
- Review of epidemiological data on appendicitis incidence.
- Analysis of diagnostic trends, including sonography and CT scanning.
- Evaluation of therapeutic approaches, focusing on laparoscopic appendectomy and stump closure methods.
Main Results:
- A consistent decrease in acute non-perforated appendicitis incidence was observed.
- The incidence of perforated appendicitis has remained static.
- Laparoscopic appendectomy has become the predominant surgical method, with no evidence of increased postoperative intraabdominal abscesses.
- Stapler use for appendiceal stump closure is now common.
Conclusions:
- Despite improved diagnostic tools and widespread laparoscopic surgery, the rate of perforated appendicitis has not declined.
- Laparoscopic appendectomy is a safe and effective standard treatment.
- Further research may be needed to understand why perforated appendicitis rates persist.
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