Appendectomy in Switzerland: how is it done?

More than 10,000 appendectomies are performed every year in Switzerland. The aim of this study was to investigate the treatment strategy for appendicitis among Swiss surgeons with particular interest in laparoscopic technique, method of appendiceal stump closure, and abdominal lavage. We performed an anonymous survey among 540 members of the Swiss Surgical Society. Technical details and differences between the surgical procedures in adults and children as well as in complicated and non-complicated appendicitis were investigated. The overall response rate was 45% (n = 243). 78% of the surgeons perform laparoscopic appendectomies in children and 95% in adult patients. Only 3% use a single incision site technique. Surgeons consider pus or stool in the abdomen (94%), an abscess (86%) or perforation of the appendix (82%), but not an inflamed appendiceal base (16%) as complicated appendicitis. 41% of surgeons use endoloops, 36% a stapling device, and 20% polymeric clips in non-complicated appendicitis for appendiceal stump closure. However, 82% of the surgeons use a stapler in complicated appendicitis. Most (76%) of surgeons do not plunge the appendiceal stump. 24% of surgeons lavage the abdomen with > 1 L of fluid independent of the intraabdominal finding. Most Swiss surgeons perform multiport laparoscopic appendectomies. Endoloops and staplers are mostly used for appendiceal stump closures in uncomplicated appendicitis, and staplers in complicated appendicitis. Only a minor part of surgeons plunge the appendiceal stump or perform routine abdominal lavage.

A beta-scintillator for surface measurements of radiotracer kinetics in the intact rodent cortex.

Beta+-sensitive probes are useful tools for the measurement of radiotracer kinetics in small animals. They allow the cost-effective development of new PET tracers and offer the possibility to investigate a variety of cerebral processes. The study's main aim was the in vivo evaluation of a probe system for cerebral surface acquisitions. The detector system is a 0.2-mm thick scintillating disk of 3-mm diameter, positioned close to the cerebral surface. The study consists of 4 subparts: (1) simulation of the detection volume, (2) direct comparison with the classic intracortical beta probe regarding its capability to acquire kinetic data, (3) test of the ability to detect local tracer accumulations during infraorbital nerve (ION) electrostimulation and (4) demonstration of the feasibility to measure tracer kinetics in awake animals. Kinetic data acquired with 18F-fluorodeoxyglucose and 15O-H2O were fitted with standard compartment models. The surface probe measurements were in good agreement with those obtained using the intracortical scintillator. ION electrostimulation induced a marked increase in tracer accumulation adequately detected by the surface probe. In the head-fixed animal, a marked change in FDG kinetics was detected between the awake and anesthetized state. The novel surface probe system proved to be a valuable instrument for in vivo radiotracer studies of the cerebral cortex. Its main advantage is the absence of any tissue damage. In addition, serial acquisitions of tracer kinetics in the awake animal turned out to be feasible.