Background: Appendicitis accounts for the most frequent surgical emergencies in childhood. The guidance from the Royal College of Surgeons and poor post operative outcomes in surgical patients during the pandemic, it would be expected that only children who had clinical signs of appendicitis and were unwell, would have undergone surgery. Hence, the negative appendicectomy rate during the pandemic should have decreased.The aim of this retrospective study was to assess the rate of negative appendicectomy amongst children <16 years of age during the first wave of the pandemic, from the announcement of the lockdown and determine if there was a true difference by comparing the rate with the same time period in 2019.
Material And Methods: Data of all children aged<16 years who were operated for appendicitis between 23/3/2020 and 30/06/2020 was collected retrospectively and compared with that of children operated during the same time period in 2019 for the rate of negative appendicectomy.Data were analysed using the two-tailed -test for continuous data and χ2 or Fishers exact tests for categorical data with p value of <0.05 considered significant.
Results: Twenty three paediatric patients presenting with acute appendicitis underwent appendicectomy during the COVID-19 pandemic and 35 patients during 2019.Overall 17.39% patients underwent laparoscopic appendicectomy in 2020 while 54.29% in 2019. The negative appendicectomy rate was zero during the pandemic while it was 17.14% in 2019. There was no difference in the median length of hospital stay during the two time periods. There was no significant difference in complication or re-admission rate.
Conclusion: This study has the lowest reported incidence of negative appendicectomy rate during the pandemic following wider use of pre operative imaging and early senior involvement in decision making. The increased number of complicated appendicitis during the pandemic did not translate to worse clinical outcomes.
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http://dx.doi.org/10.1016/j.amsu.2021.102901 | DOI Listing |
Acta Paediatr
January 2025
Department of Pathology, Sourasky Medical Center, Tel Aviv, Israel.
Aim: Diagnostic error can result in the appendectomy of a normal appendix, commonly known as negative appendectomy (NA). Missed appendicitis (MA) is related to a poor outcome. The aim of this study was to determine whether there are factors in presentation associated with NA or MA.
View Article and Find Full Text PDFWorld J Urol
January 2025
Division of Urology, Department of Surgery, The Hospital for Sick Children, Toronto, ON, Canada.
Objectives: To assess the complication rates associated with split versus intact appendix Mitrofanoff procedures using a single-center retrospective analysis and a systematic review with meta-analysis.
Subjects And Methods: The study comprised a retrospective cohort analysis at a single institution, analyzing patients who underwent a laparoscopic-assisted Mitrofanoff with or without splitting the appendix from 2005 to 2016. The focus was on complications related to both Mitrofanoff and ACE channels.
Lancet Gastroenterol Hepatol
January 2025
Department of Surgery, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam UMC, Location AMC, University of Amsterdam, Amsterdam, Netherlands. Electronic address:
Background: Randomised controlled trials (RCTs) have found antibiotics to be a feasible and safe alternative to appendicectomy in adults with imaging-confirmed acute appendicitis. However, patient inclusion criteria and outcome definitions vary greatly between RCTs. We aimed to compare antibiotics with appendicectomy for the treatment of acute appendicitis using individual patient data and uniform outcome definitions.
View Article and Find Full Text PDFJ Pediatr Surg
January 2025
Division of Pediatric Surgery, Rady Children's Hospital San Diego, San Diego, CA, USA; Division of Pediatric Surgery, Dept of General Surgery, UCSD School of Medicine, La Jolla, CA, USA. Electronic address:
Background: There is no consensus on the appropriate duration of postoperative antibiotics for complicated appendicitis in children. Commonly used antibiotic endpoints include normalization of white blood cell count (WBC) or completion of a minimum number of prespecified treatment days. We compared clinical outcomes resulting from varying postoperative antibiotic protocols for complicated appendicitis in children.
View Article and Find Full Text PDFJ Coll Physicians Surg Pak
January 2025
Department of General and Laparoscopic Surgery, Sheikh Khalifa Bin Zayed Al-Nahyan Hospital Muzaffarabad, Azad Jammu and Kashmir, Pakistan.
Objective: To determine the importance of the Glasgow Coma scale (GCS), ASA physical status classification system, and P-POSSUM score in predicting mortality among patients undergoing emergency laparotomies.
Study Design: An analytical study. Place and Duration of the Study: Department of General Surgery, Sheikh Khalifa Bin Zayed Al-Nahyan Hospital Muzaffarabad, Pakistan, from October 2020 to January 2022.
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