Background: This study aims to compare medical treatment and appendectomy in patients diagnosed with uncomplicated acute appendicitis during the COVID-19 pandemic.
Methods: Retrospectively analyzed were the data of 80 patients who received medical or surgical treatment for uncomplicated acute appendicitis between March 15, 2020, and August 31, 2020. The demographic characteristics of the patients, length of hospital stay, physical examination and radiology findings, laboratory results, and any complications were recorded. Patients were divided into two groups depending on the mode of treatment, as surgical and non-surgical.
Results: Forty patients were given medical treatment and 40 patients were directly operated on for appendicitis. Of the 40 patients who received medical treatment, 8 (20%) ended up requiring an operation due to recurrence. The mean duration of hospitalization was 2 days (range: 1-3), and the mean follow-up duration was 285.35±65.66 days (range: 101-379). The white blood cell count was significantly higher in the surgical group (p=0.004), and the length of hospital stay was longer in the non-surgical group (p<0.001). The prevalence of post-operative complications was similar for patients who underwent appendectomy directly on admission or after recurrence (p=1.000). Among the patients who received medical treatment, the most important predictors of requiring surgery were the red cell distribution width and increased appendix diameter in computed tomography (p<0.05).
Conclusion: Medical treatment is an effective alternative in patients with uncomplicated appendicitis. Even in the case of a recurrence in follow-up, surgery due to a potential recurrence is not associated with an increased rate of complication compared to direct surgery.
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http://dx.doi.org/10.14744/tjtes.2021.45944 | DOI Listing |
Ann Vasc Surg
January 2025
Division of Vascular Surgery and Endovascular Therapy, University of Florida, Gainesville, FL, USA.
The management of type B aortic dissection is one of the most challenging and debated topics in contemporary cardiovascular surgery practice. Patients with acute or chronic dissection-related complications, face high morbidity and mortality if not treated promptly. For most patients requiring intervention, thoracic endovascular aortic repair (TEVAR) is considered the gold standard.
View Article and Find Full Text PDFAnn Vasc Surg
January 2025
Section of Vascular Surgery, Cardio Thoracic Vascular Department, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.
Type B aortic dissection (TBAD) presents a complex clinical challenge requiring coordinated, multidisciplinary care to optimize patient outcomes. While rapid intervention is crucial for complicated TBAD, the optimal management of uncomplicated cases remains less well-defined. Historically, uncomplicated TBAD was managed medically, but recent years have seen a shift toward selective interventional approaches.
View Article and Find Full Text PDFAnn Vasc Surg
January 2025
University Aortic Centre Munich(LMU), LMU University Hospital, Munich, Germany; Department of Cardiac Surgery, LMU University Hospital, Munich, Germany.
Type B aortic dissection (TBAD) primarily affects men aged 60-65, with hypertension in over 80% of cases. The gold standard for the treatment of uncomplicated acute TBAD is Best Medical Therapy (BMT), which focused on controlling blood pressure and heart rate. However, Thoracic Endovascular Aortic Repair (TEVAR) has gained attention over the years, especially for complicated TBAD cases, by covering the primary entry tear, lowering false lumen pressure, and promoting aortic remodeling.
View Article and Find Full Text PDFCrohns Colitis 360
January 2025
The Dr. Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine, New York, NY, USA.
Background: Intravenous (IV) steroids are commonly used to treat acute flares of Crohn's disease (CD). However, it is unclear if they are beneficial in the setting of uncomplicated small bowel obstruction (SBO). We sought to examine if IV steroid administration improved short-term outcomes in patients with CD hospitalized for acute, uncomplicated SBO across three New York City hospital systems.
View Article and Find Full Text PDFLancet
January 2025
Division of General and Thoracic Surgery, Hospital for Sick Children, Toronto, ON, Canada.
Background: Support for the treatment of uncomplicated appendicitis with non-operative management rather than surgery has been increasing in the literature. We aimed to investigate whether treatment of uncomplicated appendicitis with antibiotics in children is inferior to appendicectomy by comparing failure rates for the two treatments.
Methods: In this pragmatic, multicentre, parallel-group, unmasked, randomised, non-inferiority trial, children aged 5-16 years with suspected non-perforated appendicitis (based on clinical diagnosis with or without radiological diagnosis) were recruited from 11 children's hospitals in Canada, the USA, Finland, Sweden, and Singapore.
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