Communication and management of incidental pathology in 1,214 consecutive appendicectomies; a cohort study
| Autor: | James Moore, Greg Otto, Eliza Bramwell, Alannah Frazzetto, Prajay Patel, Ned Kinnear, Christopher Dobbins, Derek Hennessey, Tarik Sammour, Amy Noll, Bridget Heijkoop |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Pathology medicine.medical_specialty Endometriosis Appendix Malignancy 03 medical and health sciences 0302 clinical medicine Pelvic inflammatory disease medicine Appendectomy Humans Mucinous cystadenoma Retrospective Studies business.industry Communication Retrospective cohort study General Medicine Middle Aged Diverticulitis Appendicitis medicine.disease 030220 oncology & carcinogenesis Female 030211 gastroenterology & hepatology Surgery Emergency Service Hospital business Cohort study |
| Zdroj: | International Journal of Surgery. 72:185-191 |
| ISSN: | 1743-9191 |
| DOI: | 10.1016/j.ijsu.2019.10.025 |
| Popis: | Background Important incidental pathology requiring further action is commonly found during appendicectomy, macro- and microscopically. We aimed to determine whether the acute surgical unit (ASU) model improved the management and disclosure of these findings. Methods An ASU model was introduced at our institution on 01/08/2012. In this retrospective cohort study, all patients undergoing appendicectomy 2.5 years before (Traditional group) or after (ASU group) this date were compared. The primary outcomes were rates of appropriate management of the incidental findings, and communication of the findings to the patient and to their general practitioner (GP). Results 1,214 patients underwent emergency appendicectomy; 465 in the Traditional group and 749 in the ASU group. 80 (6.6%) patients (25 and 55 in each respective period) had important incidental findings. There were 24 patients with benign polyps, 15 with neuro-endocrine tumour, 11 with endometriosis, 8 with pelvic inflammatory disease, 8 Enterobius vermicularis infection, 7 with low grade mucinous cystadenoma, 3 with inflammatory bowel disease, 2 with diverticulitis, 2 with tubo-ovarian mass, 1 with secondary appendiceal malignancy and none with primary appendiceal adenocarcinoma. One patient had dual pathologies. There was no difference between the Traditional and ASU group with regards to communication of the findings to the patient (p = 0.44) and their GP (p = 0.27), and there was no difference in the rates of appropriate management (p = 0.21). Conclusion The introduction of an ASU model did not change rates of surgeon-to-patient and surgeon-to-GP communication nor affect rates of appropriate management of important incidental pathology during appendectomy. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect