Hussam Widatella, Ahmed Abdulmanan, Ibraheem Abdelraheem, Fadi Atwan, S. Paran
{"title":"儿童年龄组急性阑尾炎伴包块形成的术前阑尾切除术与间歇阑尾切除术:主要结果差异不大","authors":"Hussam Widatella, Ahmed Abdulmanan, Ibraheem Abdelraheem, Fadi Atwan, S. Paran","doi":"10.15406/jpnc.2023.13.00505","DOIUrl":null,"url":null,"abstract":"Aim: The aim of this study is to compare Conservative treatment followed by Interval Appendicectomy, versus Emergency Appendicectomy for the management of appendicular masses in children. Methods: Retrospective review of all appendicectomy performed in Tallaght university hospital, in Paediatric Surgery Department between January 2013 and June 2016. We included 397 procedures of Appendicectomy, among those, 16% (n=64) were diagnosed as appendicular masses. Cases were classified into two groups. Group I included those who were managed conservatively and then underwent Interval Appendicectomy after 6 to 8 weeks, (n=20) 31.3%. Group II included those who were managed with Emergency Appendicectomy, (n=44) 68.8%. The outcomes in the two groups were compared based on three parameters; the duration of hospital stay, the duration of Intravenous Antibiotics and post-operative morbidities. Results: We found that the median duration of hospitalization in group I was significantly longer than in group II (10 days vs 5 days, P<0.0001). The mean duration of antibiotic therapy in group I was also significantly longer than in group II (10.4±3.17 days) vs (5.19±2.53 days), P<0.0001). Nevertheless, the overall complication rate in Group I was similar to that of group II (38.1% vs 25.6%, P=0.304). Conclusion: No major difference in outcomes between the conservative and emergency operative approaches in managing appendicular mass in children. However, operative management is more cost-effective with less duration of hospital stay, as compared to the conservative approach.","PeriodicalId":388959,"journal":{"name":"Journal of Pediatrics & Neonatal Care","volume":"152 1","pages":"0"},"PeriodicalIF":0.0000,"publicationDate":"2023-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Upfront appendectomy vs interval appendectomy in acute appendicitis with mass formation in pediatric age group: Little difference in major outcome\",\"authors\":\"Hussam Widatella, Ahmed Abdulmanan, Ibraheem Abdelraheem, Fadi Atwan, S. Paran\",\"doi\":\"10.15406/jpnc.2023.13.00505\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Aim: The aim of this study is to compare Conservative treatment followed by Interval Appendicectomy, versus Emergency Appendicectomy for the management of appendicular masses in children. Methods: Retrospective review of all appendicectomy performed in Tallaght university hospital, in Paediatric Surgery Department between January 2013 and June 2016. We included 397 procedures of Appendicectomy, among those, 16% (n=64) were diagnosed as appendicular masses. Cases were classified into two groups. Group I included those who were managed conservatively and then underwent Interval Appendicectomy after 6 to 8 weeks, (n=20) 31.3%. Group II included those who were managed with Emergency Appendicectomy, (n=44) 68.8%. The outcomes in the two groups were compared based on three parameters; the duration of hospital stay, the duration of Intravenous Antibiotics and post-operative morbidities. Results: We found that the median duration of hospitalization in group I was significantly longer than in group II (10 days vs 5 days, P<0.0001). The mean duration of antibiotic therapy in group I was also significantly longer than in group II (10.4±3.17 days) vs (5.19±2.53 days), P<0.0001). Nevertheless, the overall complication rate in Group I was similar to that of group II (38.1% vs 25.6%, P=0.304). Conclusion: No major difference in outcomes between the conservative and emergency operative approaches in managing appendicular mass in children. However, operative management is more cost-effective with less duration of hospital stay, as compared to the conservative approach.\",\"PeriodicalId\":388959,\"journal\":{\"name\":\"Journal of Pediatrics & Neonatal Care\",\"volume\":\"152 1\",\"pages\":\"0\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-07-07\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Pediatrics & Neonatal Care\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.15406/jpnc.2023.13.00505\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Pediatrics & Neonatal Care","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.15406/jpnc.2023.13.00505","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
目的:本研究的目的是比较保守治疗后间隔阑尾切除术与紧急阑尾切除术对儿童阑尾肿块的治疗效果。方法:回顾性分析2013年1月至2016年6月在Tallaght大学医院儿科外科进行的所有阑尾切除术。我们纳入了397例阑尾切除术,其中16% (n=64)被诊断为阑尾肿块。病例分为两组。第一组包括保守治疗,6 ~ 8周后行间歇阑尾切除术的患者,占31.3% (n=20)。II组包括急诊阑尾切除术患者,(n=44) 68.8%。根据三个参数比较两组的结果;住院时间、静脉注射抗生素时间和术后发病率。结果:我们发现I组的中位住院时间明显长于II组(10天vs 5天,P<0.0001)。I组的平均抗生素治疗时间(10.4±3.17天)也明显长于II组(5.19±2.53天),P<0.0001)。然而,I组的总并发症发生率与II组相似(38.1% vs 25.6%, P=0.304)。结论:保守手术与急诊手术治疗小儿阑尾肿块的疗效无显著差异。然而,与保守方法相比,手术治疗更具成本效益,住院时间更短。
Upfront appendectomy vs interval appendectomy in acute appendicitis with mass formation in pediatric age group: Little difference in major outcome
Aim: The aim of this study is to compare Conservative treatment followed by Interval Appendicectomy, versus Emergency Appendicectomy for the management of appendicular masses in children. Methods: Retrospective review of all appendicectomy performed in Tallaght university hospital, in Paediatric Surgery Department between January 2013 and June 2016. We included 397 procedures of Appendicectomy, among those, 16% (n=64) were diagnosed as appendicular masses. Cases were classified into two groups. Group I included those who were managed conservatively and then underwent Interval Appendicectomy after 6 to 8 weeks, (n=20) 31.3%. Group II included those who were managed with Emergency Appendicectomy, (n=44) 68.8%. The outcomes in the two groups were compared based on three parameters; the duration of hospital stay, the duration of Intravenous Antibiotics and post-operative morbidities. Results: We found that the median duration of hospitalization in group I was significantly longer than in group II (10 days vs 5 days, P<0.0001). The mean duration of antibiotic therapy in group I was also significantly longer than in group II (10.4±3.17 days) vs (5.19±2.53 days), P<0.0001). Nevertheless, the overall complication rate in Group I was similar to that of group II (38.1% vs 25.6%, P=0.304). Conclusion: No major difference in outcomes between the conservative and emergency operative approaches in managing appendicular mass in children. However, operative management is more cost-effective with less duration of hospital stay, as compared to the conservative approach.