Unexpected findings after surgery for suspected appendicitis rarely change treatment in pediatric patients; Results from a cohort study
| Autor: | Johanna H. van der Lee, Paul van Amstel, Ramon R. Gorter, Patick van der Voorn, Roel Bakx, Hugo A. Heij |
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| Přispěvatelé: | Other departments, Amsterdam Reproduction & Development (AR&D), APH - Quality of Care, APH - Methodology, General Paediatrics, Paediatric Surgery, Amsterdam Gastroenterology Endocrinology Metabolism, AGEM - Re-generation and cancer of the digestive system, Surgery, Other Research, Pediatrics |
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Torsion Abnormality Adolescent Endometriosis Carcinoid Tumor Appendix 03 medical and health sciences 0302 clinical medicine Medicine Appendectomy Humans Ovarian Diseases Child Retrospective Studies Incidental Findings business.industry Incidence (epidemiology) Incidence Ovarian torsion Infant Retrospective cohort study Enterobiasis General Medicine medicine.disease Appendicitis Surgery medicine.anatomical_structure Appendiceal Neoplasms 030220 oncology & carcinogenesis Concomitant Child Preschool Pediatrics Perinatology and Child Health Acute Disease 030211 gastroenterology & hepatology Female business Cohort study |
| Zdroj: | Gorter, R R, van Amstel, P, van der Lee, J H, van der Voorn, P, Bakx, R & Heij, H A 2017, ' Unexpected findings after surgery for suspected appendicitis rarely change treatment in pediatric patients; Results from a cohort study ', Journal of Pediatric Surgery, vol. 52, no. 8, pp. 1269-1272 . https://doi.org/10.1016/j.jpedsurg.2017.02.012 Journal of pediatric surgery, 52(8), 1269-1272. W.B. Saunders Ltd Journal of Pediatric Surgery, 52(8), 1269-1272. W.B. Saunders Ltd |
| ISSN: | 0022-3468 |
| DOI: | 10.1016/j.jpedsurg.2017.02.012 |
| Popis: | Background To determine if non-operative treatment is safe in children with acute appendicitis, we evaluated the incidence of unexpected findings after an appendectomy in children, and the influence they have on subsequent treatment. Methods A historical cohort study (January 2004–December 2014) was performed including children, aged 0–17 years, who underwent an appendectomy for the suspicion of acute appendicitis. Patients were divided based upon histopathological examination. Unexpected findings were reviewed, as well as the subsequent treatment plan. Results In total 484 patients were included in this study. In the overall group, unexpected findings were noted in 10 (2.1%) patients of which two patients intra-operatively with a non-inflamed appendix (Ileitis terminalis N = 1 and ovarian torsion N = 1) and in 8 patients on histopathological examination. The latter group consisted of 4 patients with concomitant simple appendicitis (parasitic infection N = 3 and Walthard cell rest N = 1), two with concomitant complex appendicitis (carcinoid N = 1 and parasitic infection N = 1) and two patients with a non-inflamed appendix (endometriosis N = 1 and parasitic infection N = 1). Treatment was changed in 4 patients ( Conclusions Results from this study corroborate the safety of non-operative strategy for acute simple appendicitis, as the occurrence of unexpected findings was low, with extremely few necessary changes of the treatment plan because of serious findings. Type of study Prognosis study. Level of evidence Level 2 (retrospective cohort study). |
| Databáze: | OpenAIRE |
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