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Preoperative predictor of extensive resection for acute appendicitis
Fumitaka Saida1, Shokei Matsumoto1, Mitsuhide Kitano1
1Department of Trauma and Emergency Surgery, Saiseikai Yokohamashi Tobu Hospital, Japan.
American Journal of Surgery
|July 13, 2017
Summary
Extensive resection (ER) for acute appendicitis is sometimes necessary. Appendiceal mass, non-visualization of appendix, delayed admission, and C-reactive protein (CRP) levels predict the need for ER.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Abdominal Surgery
Background:
- Appendectomy is the standard treatment for acute appendicitis.
- Extensive resection (ER), including ileocecal resection, may be required in complex cases.
- Predictive factors for ER in acute appendicitis require further investigation.
Purpose of the Study:
- To identify preoperative predictors of extensive resection (ER) in patients with acute appendicitis.
- To improve surgical decision-making and patient management for acute appendicitis requiring ER.
Main Methods:
- Retrospective analysis of 927 patients with acute appendicitis over 7 years.
- Data collected included demographics, laboratory results, computed tomography (CT) findings, and time from symptom onset.
- Multivariate analysis was used to identify significant predictors of ER.
Main Results:
- Extensive resection (ER) was performed in 4.3% of patients.
- Factors significantly associated with ER included appendiceal mass, non-visualization of the appendix on CT, delayed admission, and elevated C-reactive protein (CRP) levels.
- Appendiceal mass, non-visualization of appendix, delayed admission, and CRP were significant independent predictors of ER.
Conclusions:
- Four key factors (appendiceal mass, non-visualization of appendix, delayed admission, CRP) can reliably predict the need for ER preoperatively.
- These predictive factors can aid in surgical planning, including procedure selection and anesthesia.
- Accurate preoperative prediction of ER can optimize patient outcomes in acute appendicitis management.
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