Concordancia entre los hallazgos quirúrgicos e histopatológicos en pacientes con apendicitis aguda en un hospital de tercer nivel de Bogotá, Colombia

Autor: Oliveros Rodríguez, Henry, Díaz Quijano, Diana Marcela, Kock, Joshua
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: Revista Colombiana de Cirugía, Volume: 35, Issue: 3, Pages: 449-454, Published: 08 FEB 2021
Popis: Introduction. Currently surgical findings dictate the post-operative treatment of patients with acute appendicitis; however, this relies only on the judgement of the surgeon during the appendectomy. This study aimed to determine the inter-rater reliability between surgeons and pathologists at a tertiary hospital. Methods. This was a cross-sectional retrospective study conducted between October 2015 and October 2016 at the Central Military Hospital in Bogotá. Patients who underwent appendectomy due to suspected acute appendicitis and had histopathological with their respective surgical findings were included. Our aim was to determine the agreement between surgical and pathology reports. Results. During the study period, we identified 418 patients who underwent appendectomy. Surgeons assessed 32 (7.77%) appendix as negative, 78 (18.93%) as inflamed, 110 (26.7%) as suppurative, 137 (33.25%) gangrenous and 55 (13.35%) as perforated. Highest agreement was observed in patients with suppurative appendicitis (82/110; 74.5%). Overall Kappa indicated a poor-fair agreement between the pathologist and surgeons (Kappa = 0.2950, 95% CI 0.2384-035.17, p < 0.0001). Conclusion. There is a poor concordance between surgical and pathologic findings in our study, which is similar to previous articles. As a take home message, surgeons and pathologist should revise the definition of the clinical and the histopathological criteria to better describe the findings and reach a better agreement. Resumen Introducción. Los hallazgos quirúrgicos actuales dictan el tratamiento postoperatorio de los pacientes con apendicitis aguda; sin embargo, esto se basa únicamente en el juicio del cirujano durante la apendicectomía. Este estudio tuvo como objetivo determinar la correlación de la evaluación entre cirujanos y patólogos en un hospital de tercer nivel. Métodos. Estudio transversal retrospectivo realizado entre octubre de 2015 y octubre de 2016 en el Hospital Militar Central de Bogotá. Se incluyeron pacientes que se sometieron a apendicectomía debido a sospecha de apendicitis aguda y tenían histopatología con sus respectivos hallazgos quirúrgicos. Nuestro objetivo fue determinar la concordancia entre el informe quirúrgico y el de patología. Resultados. Durante el período de estudio, identificamos a 418 pacientes que se sometieron a apendicectomía. Los cirujanos evaluaron 32 (7,77%) apéndices como negativos, 78 (18,93%) como inflamados, 110 (26,7%) como supurativos, 137 (33,25%) gangrenosos y 55 (13,35%) como perforados. La mayor concordancia se observó en pacientes con apendicitis supurativa (82/110; 74.5%). En general, Kappa indicó un acuerdo poco equitativo entre el patólogo y los cirujanos (Kappa = 0.2950, IC 95% 0.2384-035.17, p
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