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Laparoscopic Appendectomy in the Days of COVID-19
Roi Abramov1, Mariya Neymark1, Asaf Harbi1,2
1Department of General Surgery.
Insights
The COVID-19 pandemic led to more complicated acute appendicitis cases requiring laparoscopic appendectomy. Patients with persistent symptoms should seek immediate emergency care to avoid delayed treatment.
Area of Science:
- General Surgery
- Infectious Disease Epidemiology
Background:
- Acute appendicitis is a common surgical emergency.
- Laparoscopic appendectomy is the standard treatment.
- The COVID-19 pandemic raised concerns about delayed patient presentation and disease severity.
Purpose of the Study:
- To evaluate the impact of the COVID-19 pandemic on the presentation and management of acute appendicitis.
- To compare appendicitis cases during the pandemic with the previous year.
Main Methods:
- Retrospective review of a tertiary center's database.
- Comparison of laparoscopic appendectomy patients in 2020 (pandemic) versus 2019.
- Analysis of disease complexity and surgical interventions.
Main Results:
- A higher number of complicated appendicitis cases were observed during the pandemic (41 in 2020 vs. 22 in 2019).
- Increased use of peritoneal drains and stapler devices for appendiceal stump closure during the pandemic.
- Total laparoscopic appendectomies increased slightly in 2020 (123) compared to 2019 (109).
Conclusions:
- The COVID-19 pandemic was associated with a significant rise in complicated appendicitis.
- Patients are urged to seek prompt medical attention for persistent appendicitis symptoms, even during a pandemic.
Background:
Acute appendicitis is one of the most common emergencies treated by general surgeons. The treatment of choice in the majority of cases is laparoscopic appendectomy. In the era of the COVID-19 pandemic, there is a concern for a delayed referral of patients and thus a more advanced presentation of the disease leading to a prolonged and complicated course.
Methods:
Retrospective review of a computerized database of patients who were admitted with acute appendicitis and underwent laparoscopic appendectomy during the COVID pandemic in a single tertiary center in Israel. Patients were compared with those who were admitted and operated for appendicitis in the same period in the previous year.
Results:
One hundred twenty-three patients underwent laparoscopic appendectomy in the study period in 2020, compared with 109 who had surgery in 2019. During the COVID pandemic 41 patients presented with complicated appendicitis versus 22 patients in 2019 (P=0.0174). The placement of peritoneal drains was more prevalent during the pandemic, 5.5% versus 11.4%, and the use of stapler device for appendicular stump closure (P=0.0105).
Conclusions:
During the first stage of the COVID-19 pandemic, there was a significant increase in the rate of complicated appendicitis. Patients should be strongly encouraged not to refrain from medical treatment and go to the emergency room with the persistence of symptoms.
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