To study comparative results between laparoscopic and open appendectomy, all the patients with suspected acute appendicitis who presented between January 1992 and December 1994 (N = 210) were randomized into two groups: laparoscopic (LA, n = 106) and open appendectomy (OA, n = 104). Patient demographics, pathological findings, operative time, postoperative course, and cost were analyzed. Age, gender, previous laparotomy, intraoperative diagnosis, and perforated appendix rate were comparable between both groups. Mean operative time was longer in the LA group (p < 0.05). Earlier resumption of a regular diet, shorter postoperative stay, and less postoperative analgesia also were observed in the LA group (p < 0.05). Postoperative morbidity and hospital readmissions were similar in both groups (p > 0.05). Higher operative cost was observed in the LA group, but global cost was lower in this group (p < 0.05). Laparoscopic appendectomy shows a more comfortable postoperative course (oral resumption, postoperative stay, and analgesia) over open appendectomy, with similar postoperative morbidity. The LA group showed more operative but less global cost.
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Cureus
December 2024
Obstetrics and Gynecology, Vassar Brothers Medical Center, Poughkeepsie, USA.
This case reports a 44-year-old female who presented to the gynecologic oncology clinic status post robotic-assisted laparoscopic myomectomy with intraperitoneal unprotected power morcellation in 2012, with an incidental finding of three conglomerate solid masses in the abdomen above the uterus, with each mass measuring approximately 15.5 cm. The patient underwent an exploratory laparotomy where multiple masses greater than 10 cm were found scattered throughout the abdominal cavity.
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December 2024
Surgery, SSM (Sisters of Saint Mary) Health Good Samaritan Hospital, Mount Vernon, USA.
Stump appendicitis is a known post-appendectomy entity causing right lower quadrant abdominal pain. Usually, a patient with a prior history of appendectomy presents to the emergency room with right lower quadrant abdominal pain and stump appendicitis, which is visualized on computed tomography of the abdomen pelvis. We report a case of stump appendicitis diagnosed by colonoscopy and subsequently confirmed by surgery.
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January 2025
Colorectal Surgery, St Mary's Hospital, Isle of Wight NHS Trust, Newport, GBR.
Meckel's diverticulum (MD) is the most common congenital abnormality of the gastrointestinal tract. It usually lies on the antimesenteric side of the ileum, about 60 cm from the ileocecal valve. Histologically, it is a true diverticulum comprising all four layers of the intestinal tract.
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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.
Int J Gynaecol Obstet
January 2025
Department of Obstetrics and Gynecology, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague 10, Czech Republic.
Negative pressure wound therapy (NPWT) is a very effective method in the treatment of dehiscent, infected, and non-healing wounds. Difficult wound healing occurs especially in late pregnancy due to the rapid enlargement of the uterus and the constantly increasing tension of the entire abdominal wall. In cases of dehiscence of the surgical wound during pregnancy, proper subsequent treatment is needed, where it is necessary to consider the safety of the mother as well as the fetus.
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