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1.
J Cardiothorac Surg ; 19(1): 169, 2024 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-38566062

RESUMO

BACKGROUND: Atrial tachycardia (AT) originating from the left atrial appendage (LAA) is uncommon and the most difficult arrhythmia to eliminate. Therefore, we present the case of a 5-year-old girl with tachycardia-induced cardiomyopathy (TIC) caused by AT originating from the LAA and successfully treated with RFCA associated to left atrial appendectomy. With resolution of AT, we observed a progressive improvement of LV function. The effectiveness and safety of this combination therapy were evaluated over a one-month follow-up period. CASE PRESENTATION: A 5 -year-old female was evaluated for three days of incessant cough and a syncopal episode. Surface echocardiography and 24-hour monitoring showed that the infant had persistent atrial tachycardia. Echocardiography revealed an enlarged tele diastolic diameter (46.1 mm) and malfunctioning (EF 28.53%) left ventricle. The location of the lesion at the apex of the LAA was further confirmed by electrophysiological study and RFCA. After RFCA, the infant's ECG monitor showed that sinus rhythm was maintained for up to 22 h. Subsequently, atrial tachycardia recurred and sinus rhythm disappeared. Finally, atrial appendectomy was performed and sinus rhythm returned to normal. CONCLUSIONS: The heart function of the infant improved and sinus rhythm was maintained, further demonstrating the safety and effectiveness of combined treatment with RFCA and atrial appendectomy after electrophysiological localization of AT from LAA to TIC.


Assuntos
Cardiomiopatias , Ablação por Cateter , Pré-Escolar , Feminino , Humanos , Apendicectomia , Cardiomiopatias/cirurgia , Átrios do Coração/cirurgia , Taquicardia/cirurgia
2.
BMJ Case Rep ; 17(4)2024 Apr 16.
Artigo em Inglês | MEDLINE | ID: mdl-38627055

RESUMO

Acute diverticulitis of the appendix (ADA), though uncommon, often presents similarly to acute appendicitis but carries a higher risk of complications such as perforation and malignancy. We report the case of a male patient in his 50s with acute right iliac fossa abdominal pain, diagnosed via CT scan with ADA. Urgent laparoscopic appendicectomy was performed, and the patient was discharged without further issues. This case highlights the importance of promptly identifying and managing such conditions to minimise complications and improve outcomes. Despite the overlap in symptoms between appendiceal diverticulitis and acute appendicitis, accurate diagnosis is crucial for appropriate treatment. Healthcare providers should maintain a high index of suspicion, particularly in older patients presenting with an acute appendicitis, like clinical picture to ensure timely intervention and optimal patient care.


Assuntos
Abdome Agudo , Apendicite , Apêndice , Diverticulite , Humanos , Masculino , Idoso , Apêndice/diagnóstico por imagem , Apêndice/cirurgia , Apêndice/patologia , Apendicite/diagnóstico por imagem , Apendicite/cirurgia , Diagnóstico Diferencial , Diverticulite/diagnóstico por imagem , Diverticulite/cirurgia , Apendicectomia/efeitos adversos , Dor Abdominal/diagnóstico , Abdome Agudo/diagnóstico , Doença Aguda , Dor Pélvica/complicações
3.
J Laparoendosc Adv Surg Tech A ; 34(4): 380-385, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38573162

RESUMO

Background: Transumbilical laparoscopy-assisted appendectomy (TULAA) is the technique of choice for all types of appendicitis. However, the technique is challenging for trainees to learn in comparison with performing conventional three-port laparoscopic appendectomy (CTPLA) in children. We aimed to compare the surgical outcomes of children with appendicitis treated by TULAA versus CTPLA performed by pediatric surgeons in training (PSITs). Materials and Methods: This retrospective study analyzed pediatric patients with acute appendicitis treated with CTPLA or TULAA between April 2016 and December 2022. Operative time (OT: minutes), pneumoperitoneum time (PT: minutes), blood loss (milliliter), length of hospital stay (days), and surgical site infection rate were compared between the two groups. Operative outcomes were also analyzed according to type of appendicitis such as uncomplicated and complicated cases. Results: Two hundred twenty-five laparoscopic appendectomies were performed by CTPLA (n = 94) or TULAA (n = 131). All cases were performed by PSITs and there was no open conversion cases. TULAA had a shorter OT (67.0 ± 28.4 versus 78.3 ± 21.7; P < .01) and PT (26.1 ± 17.4 versus 52.5 ± 22.1 min; P < .01). The surgical site infection rate was slightly higher in the TULAA group, but the difference was not statistically significant. In uncomplicated appendicitis (n = 164), significant differences between the CTPLA and TULAA groups were observed in OT (CTPLA versus TULAA: 70.7 ± 14.9 versus 59.1 ± 21.6, P < .01) and PT (CTPLA versus TULAA: 43.6 ± 13.1 versus 20.4 ± 13.6, P < .01). With regard to postoperative complications, only surgical site infection was significantly different between the CTPLA and TULAA groups (CTPLA: 0.0% versus TULAA: 8.2%, P < .05). In complicated cases (n = 61), there were significant differences between the groups in PT (CTPLA versus TULAA: 73.4 ± 24.9 versus 42.3 ± 17.2, P < .01) and length of hospital stay (CTPLA versus TULAA: 7.0 ± 1.3 versus 8.9 ± 4.7, P < .05). Conclusions: TULAA had a shorter OT and PT than CTPLA. TULAA for PSITs shows similar safety and feasibility to CTPLA for not only uncomplicated cases but also complicated cases.


Assuntos
Apendicite , Laparoscopia , Cirurgiões , Humanos , Criança , Apendicectomia , Apendicite/cirurgia , Estudos Retrospectivos , Infecção da Ferida Cirúrgica
4.
Int Wound J ; 21(3): e14539, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38506317

RESUMO

This study aimed to comprehensively evaluate the effects of evidence-based nursing (EBN) intervention on wound infection and postoperative complications in patients after appendectomy for acute appendicitis (AA), with the expectation of providing a theoretical basis for postoperative care in AA. Randomised controlled trials (RCTs) on the postoperative application of EBN in patients with AA were searched in PubMed, Web of Science, Cochrane Library, Embase, China Biomedical Literature Database, Wanfang and China National Knowledge Infrastructure from the inception of databases to October 2023. Two authors screened and evaluated the literature based on the inclusion and exclusion criteria, and data were extracted from the final included literature. Stata software (version 17.0) was employed for data analysis. In total, 29 RCTs involving 2848 patients with AA were included, with 1424 in the EBN group and 1424 in the conventional care group. The analyses revealed that patients with AA who experienced EBN were significantly less likely to develop postoperative wound infections (odds ratio [OR] = 0.23, 95% confidence intervals [CIs]: 0.14-0.38, p < 0.001) and postoperative complications (OR = 0.20, 95% CI: 0.15-0.26, p < 0.001) as opposed to conventional care. Available evidence suggests that EBN can effectively reduce the risk of wound infection and postoperative complications in patients undergoing appendectomy for AA, thereby improving patient prognosis. This finding is worth promoting in the clinical practice.


Assuntos
Apendicite , Infecção da Ferida Cirúrgica , Humanos , Infecção da Ferida Cirúrgica/etiologia , Apendicite/cirurgia , Enfermagem Baseada em Evidências , Apendicectomia/efeitos adversos , China/epidemiologia
5.
Pediatr Surg Int ; 40(1): 86, 2024 Mar 21.
Artigo em Inglês | MEDLINE | ID: mdl-38512596

RESUMO

OBJECTIVE: Loop ligation of the appendix is a challenging surgical skill and well suited to be trained in a simulator. We aimed to develop an affordable and easy-to-build simulator and test its training effect. DESIGN AND PARTICIPANTS: Different materials were tested, and the best training modality was identified by researching the literature. The developed simulator training was tested on 20 surgical novices. RESULTS: A video was produced including an instruction on how to build the simulator and a step-by-step tuition on how to ligate the appendix. The Peyton approach was utilized to guide learners. Training with the simulator leads to reliable skill acquisition. All participants improved significantly in completing the task successfully during the structured learning. CONCLUSION: We succeeded in developing a simulator for loop ligation of the appendix during laparoscopic appendectomy. Participants significantly improve in handling the loops. The transferability of the skill learned during simulation to the operating room will be subject of a follow-up study.


Assuntos
Laparoscopia , Treinamento por Simulação , Humanos , Seguimentos , Apendicectomia , Laparoscopia/educação , Simulação por Computador , Competência Clínica
10.
J Med Case Rep ; 18(1): 188, 2024 Mar 29.
Artigo em Inglês | MEDLINE | ID: mdl-38549166

RESUMO

BACKGROUND: Duplex or vermiform appendix refers to the presence of an appendix beside the naturally occurring one. Although, duplex appendix emerges from the caecum most of the time, yet it is encountered in other parts of the colon. Inflammation of duplex appendix may represent not only a clinical, but also a surgical dilemma, and this would be confusing further among patients who already had prior appendectomy. CASE PRESENTATION: We present a case of 29-years old Egyptian male patient with history of appendectomy one and half year before presenting to the emergency department with recurrent acute abdominal pain that was linked to duplex appendicitis abnormally emerged from the mid-ascending colon. The first episode was treated conservatively considering atypical right colon diverticulitis as a potential differential diagnosis. Seven months later the patient was treated by laparoscopic appendectomy and experienced an uneventful pot-operative course. CONCLUSION: Duplex appendicitis, though rare, should be considered in the differential diagnosis of recurrent acute abdomen even after appendectomy.


Assuntos
Apendicite , Apêndice , Diverticulite , Humanos , Masculino , Adulto , Apêndice/diagnóstico por imagem , Apêndice/cirurgia , Apendicite/complicações , Apendicite/diagnóstico por imagem , Apendicite/cirurgia , Colo Ascendente/diagnóstico por imagem , Colo Ascendente/cirurgia , Apendicectomia , Diverticulite/cirurgia
11.
Langenbecks Arch Surg ; 409(1): 87, 2024 Mar 05.
Artigo em Inglês | MEDLINE | ID: mdl-38441707

RESUMO

INTRODUCTION: Appendiceal neoplasms (ANs) are rare, with an estimated incidence of around 1%: neuroendocrine tumours (NETs) and low-grade appendiceal mucinous neoplasms (LAMNs) comprise most cases. Most tumours are cured by appendectomy alone, although some require right hemicolectomy and intra-operative chemotherapy. The aim of the present study is to evaluate our institution's experience in terms of the prevalence of AN, their histological types, treatment and outcomes in adult patients undergoing emergency appendectomy. MATERIAL AND METHODS: Single-centre retrospective cohort analysis of patients treated for acute appendicitis at a large academic medical centre. Patients with a diagnosis of acute appendicitis (AA) where further compared with patients with acute appendicitis and a histologically confirmed diagnosis of appendiceal neoplasm (AN). RESULTS: A diagnosis of acute appendicitis was made in 1200 patients. Of these, 989 patients underwent emergency appendectomy. The overall incidence of appendiceal neoplasm was 9.3% (92 patients). AN rate increased with increasing age. Patients under the age of 30 had a 3.8% (14/367 patients) rate of occult neoplasm, whereas patients between 40 and 89 years and older had a 13.0% rate of neoplasm. No difference was found in clinical presentations and type of approach while we found a lower complicated appendicitis rate in the AN group. CONCLUSION: ANs are less rare with respect to the literature; however, clinically, there are no specific signs of suspicious and simple appendicectomy appears to be curative in most cases. However, age plays an important role; older patients are at higher risk for AN. ANs still challenge the non-operative management concept introduced into the surgical literature.


Assuntos
Neoplasias do Apêndice , Apendicite , Adulto , Humanos , Apendicite/epidemiologia , Apendicite/cirurgia , Neoplasias do Apêndice/epidemiologia , Neoplasias do Apêndice/cirurgia , Apendicectomia , Estudos Retrospectivos , Doença Aguda
12.
Langenbecks Arch Surg ; 409(1): 89, 2024 Mar 08.
Artigo em Inglês | MEDLINE | ID: mdl-38457041

RESUMO

PURPOSE: Polymeric clips (Hem-o-lok ligation system) are now widely used to securing the base of the appendix during laparoscopic appendectomy. Studies comparing the use of single or double hem-o-lok clips are limited. The aim of this study was to compare the reliability of a single hem-o-lok clips with a double hem-o-lok clips for closure of an appendiceal stump. METHODS: This prospective randomized study includes patients from two centers who underwent laparoscopic appendectomy with the diagnosis of appendicitis between September 2020 and March 2023. Demographic, operative and clinical outcomes of the use of single or double hem-o-lok clips for closure of the appendiceal stump were compared. Factors affecting long postoperative hospital stay were investigated using univariate and multivariate analyzes. RESULTS: One hundred forty two (48.3%) patients in the single hem-o-lok arm and 152 (51.7%) patients in the double hem-o-lok arm were included in the analysis.The shortest operative time was noted in the single hem-o-lok group (52.1 ± 19.9 versus 61.6 ± 24.9 min, p < 0.001). The median hospital stay was 1 day (range 1-10) in the single hem-o-lok group and 1 day (range 1-12) in the double hem-o-lok group, and was shorter in the single hem-o-lok arm (1.61 ± 1.56 vs 1.84 ± 1.69, p = 0.019). Based on multivariate analysis, drain placement was identified as an independent predictive factor for long hospital stay. CONCLUSIONS: The use of single hem-o-lok clips for appendiceal stump closure during laparoscopic appendectomy is safe and effective. Trial registration NCT04387370 ( http://www. CLINICALTRIALS: gov ).


Assuntos
Apendicite , Laparoscopia , Humanos , Apendicectomia , Estudos Prospectivos , Reprodutibilidade dos Testes , Apendicite/cirurgia , Instrumentos Cirúrgicos
13.
BMJ Case Rep ; 17(3)2024 Mar 06.
Artigo em Inglês | MEDLINE | ID: mdl-38453231

RESUMO

This case report involves an elderly woman who presented with a 3-day history of a tender groin swelling on her right side. Her admission bloods were fairly unremarkable, but a preoperative ultrasound impressively confirmed a femoral hernia containing the appendix (De Garengeot hernia) and she underwent emergency laparoscopic hernioplasty with a prosthetic mesh and appendicectomy. The procedure found an incarcerated hernia with a strangulated tip of the appendix that unexpectedly separated upon gentle manipulation and histopathology revealed appendiceal inflammation. There were no complications with the patient's recovery and she was discharged 2 days after surgery.


Assuntos
Apêndice , Hérnia Femoral , Laparoscopia , Feminino , Humanos , Idoso , Apêndice/cirurgia , Apendicectomia/métodos , Hérnia Femoral/diagnóstico , Hérnia Femoral/diagnóstico por imagem , Herniorrafia/métodos
14.
J Med Case Rep ; 18(1): 194, 2024 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-38553756

RESUMO

BACKGROUND: Amyand's hernia (AH) is an appendix (with or without acute inflammation) trapped within an inguinal hernia. Most AH with acute appendicitis had a preexisting appendix within the hernia sac. We herein report a variant of AH that has never been described before. An inflamed appendix that was managed conservatively was found to have migrated and trapped in the sac of a previously unrecognized right inguinal hernia 6 weeks after the index admission, resulting in a secondary Amyand's hernia. CASE PRESENTATION: A 25-year-old healthy Taiwanese woman had persistent right lower abdominal pain for 1 week and was diagnosed with perforated appendicitis with a localized abscess by abdominal computed tomography (CT). No inguinal hernia was noted at that time. Although the inflamed appendix along with the abscess was deeply surrounded by bowel loops so that percutaneous drainage was not feasible, it was treated successfully with antibiotics. However, she was rehospitalized 6 weeks later for having a painful right inguinal bulging mass for a week. Abdominal CT revealed an inflamed appendix with abscess formation in an indirect inguinal hernia raising the question of a Amyand's hernia with a perforated appendicitis. Via a typical inguinal herniorrhaphy incision, surgical exploration confirmed the diagnosis, and it was managed by opening the hernial sac to drain the abscess and reducing the appendix into the peritoneal cavity, followed by conventional tissue-based herniorrhaphy and a laparoscopic appendectomy. She was then discharged uneventfully and remained well for 11 months. CONCLUSIONS: Unlike the traditional definition of Amyand's hernia, where the appendix is initially in the hernia sac, the current case demonstrated that Amyand's hernia could be a type of delayed presentation following initial medical treatment of acute appendicitis. However, it can still be managed successfully by a conventional tissue-based herniorrhaphy followed by laparoscopic appendectomy.


Assuntos
Apendicite , Hérnia Inguinal , Laparoscopia , Feminino , Humanos , Adulto , Apendicectomia/métodos , Apendicite/complicações , Apendicite/diagnóstico por imagem , Apendicite/cirurgia , Hérnia Inguinal/complicações , Hérnia Inguinal/diagnóstico por imagem , Hérnia Inguinal/cirurgia , Herniorrafia/métodos , Abscesso/complicações , Doença Aguda
16.
Langenbecks Arch Surg ; 409(1): 105, 2024 Mar 27.
Artigo em Inglês | MEDLINE | ID: mdl-38538959

RESUMO

BACKGROUND: Glucocorticoids are conventionally associated with increased postoperative infection risk. It is necessary to clarify if preoperative glucocorticoid exposure is associated with postoperative infection in appendectomy patients and if the association is different for open and laparoscopic appendectomies. METHODS: A Danish nationwide study of appendectomy patients between 1996 and 2018. Exposures were defined as high (≥ 5 mg) versus no/low (< 5 mg) glucocorticoid exposure in milligram prednisone-equivalents/day preoperatively. The main outcome was any postoperative infection. Then, 90-day cumulative incidences (absolute risk) and adjusted hazard ratios (relative risk) of the outcome were calculated for high versus no/low glucocorticoid exposure within all appendectomies and within open and laparoscopic subgroups. Propensity-score matching was used for sensitivity analysis. RESULTS: Of 143,782 patients, median age was 29 years, 74,543 were female, and 7654 experienced at least one infection during the 90-day follow-up. The 90-day cumulative incidence for postoperative infection was 5.3% within the no/low glucocorticoid exposure group and 10.0% within the high glucocorticoid exposure group. Compared to no/low glucocorticoid exposure, adjusted hazard ratios for 90-day postoperative infection with high glucocorticoid exposure were 1.25 [95% CI 1.02-1.52; p = 0.03] for all appendectomies, 1.59 [1.16-2.18; p = 0.004] for laparoscopic appendectomies, and 1.09 [0.85-1.40; p = 0.52] for open appendectomies (pinteraction < 0.001). The results were robust to sensitivity analyses. CONCLUSION: Preoperative high (≥ 5 mg/day) glucocorticoid exposure was associated with increased absolute risk of postoperative infections in open and laparoscopic appendectomies. The relative risk increase was significant for laparoscopic but not open appendectomies, possibly due to lower absolute risk with no/low glucocorticoid exposure in the laparoscopic subgroup.


Assuntos
Apendicite , Laparoscopia , Humanos , Feminino , Adulto , Masculino , Apendicectomia/efeitos adversos , Apendicectomia/métodos , Glucocorticoides/efeitos adversos , Apendicite/cirurgia , Complicações Pós-Operatórias/induzido quimicamente , Complicações Pós-Operatórias/epidemiologia , Laparoscopia/efeitos adversos , Dinamarca/epidemiologia , Estudos Retrospectivos , Tempo de Internação
17.
Trials ; 25(1): 218, 2024 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-38532488

RESUMO

BACKGROUND: The primary treatment of ulcerative colitis (UC) is medical therapy using a standard step-up approach. An appendectomy might modulate the clinical course of UC, decreasing the incidence of relapses and reducing need for medication. The objective of the ACCURE trial is to assess the efficacy of laparoscopic appendectomy in addition to standard medical treatment in maintaining remission in UC patients. This article presents the statistical analysis plan to evaluate the outcomes of the ACCURE trial. DESIGN AND METHODS: The ACCURE trial was designed as a multicentre, randomised controlled trial. UC patients with a new diagnosis or a disease relapse within the past 12 months, treated with 5-ASA, corticosteroids, or immunomodulators until complete clinical and endoscopic remission (defined as total Mayo score < 3 with endoscopic subscore of 0 or 1), were counselled for inclusion. Also, patients previously treated with biologicals who had a washout period of at least 3 months were considered for inclusion. Patients were randomised (1:1) to laparoscopic appendectomy plus maintenance treatment or a control group (maintenance therapy only). The primary outcome is the 1-year UC relapse rate (defined as a total Mayo-score ≥ 5 with endoscopic subscore of 2 or 3, or clinically as an exacerbation of symptoms and rectal bleeding or FCP > 150 or intensified medical therapy other than 5-ASA therapy). Secondary outcomes include number of relapses per patient, time to first relapse, disease activity, number of colectomies, medication usage, and health-related quality of life. DISCUSSION: The ACCURE trial will provide comprehensive evidence whether adding an appendectomy to maintenance treatment is superior to maintenance treatment only in maintaining remission in UC patients. TRIAL REGISTRATION: Dutch Trial Register (NTR) NTR2883 . Registered May 3, 2011. ISRCTN, ISRCTN60945764 . Registered August 12, 2019.


Assuntos
Colite Ulcerativa , Humanos , Colite Ulcerativa/tratamento farmacológico , Apendicectomia , Qualidade de Vida , Indução de Remissão , Recidiva Local de Neoplasia , Mesalamina , Recidiva , Progressão da Doença
18.
Eur J Surg Oncol ; 50(4): 108051, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38430702

RESUMO

BACKGROUND: Paediatric appendiceal neuroendocrine tumours (appNET) are very rare tumours, mostly detected incidentally by histopathological evaluation after appendectomy. Treatment recommendations are based on adult data considering high-risk NET as defined by European Neuroendocrine Tumour Society (ENETS) guidelines for completion right-sided hemicolectomy (RHC). Recent data suggest that less aggressive therapy may be justified. PROCEDURE: Analysis of children and adolescents with appNET prospectively registered with the German Malignant Endocrine Tumour (MET) studies between 1997 and 2022. RESULTS: By December 2022, 662 patients (64.7% females, 35.3% male) had been reported. Median age was 13.3 years [4.5-17.9], median duration of follow-up 2.2 years [0-10.9]. No distant metastases were reported. Tumour size was <1 cm in 63.5%, 1-2 cm in 33.2%, and >2 cm in 3.2% of patients. WHO grade 1 and 2 tumours were diagnosed in 76.9% and 23.1% of patients, respectively. Lymphovascular invasion and lymph node metastases were associated with tumour size ≥1.5 cm. 27.0% of patients presented with high-risk NET according to ENETS criteria. Of those, only 55.9% underwent secondary oncological right hemicolectomy. Neither distant metastases, nor recurrences or disease-related deaths occurred in patients with appendectomy only as well as in patients with completion RHC. Overall and event-free survival were both 100%. CONCLUSIONS: Internationally harmonized consensus recommendations on treatment of children and adolescents with appendiceal NET are urgently needed to avoid completion RHC in high-risk patients.


Assuntos
Neoplasias do Apêndice , Neoplasias das Glândulas Endócrinas , Neoplasias Intestinais , Tumores Neuroendócrinos , Neoplasias Pancreáticas , Neoplasias Gástricas , Adulto , Feminino , Adolescente , Humanos , Masculino , Criança , Metástase Linfática , Tumores Neuroendócrinos/patologia , Neoplasias do Apêndice/patologia , Apendicectomia , Neoplasias das Glândulas Endócrinas/cirurgia , Colectomia , Estudos Retrospectivos
19.
Ann Ital Chir ; 95(1): 105-108, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38469602

RESUMO

BACKGROUND: Laparoscopic appendectomy has gained prominence in the management of acute appendicitis, necessitating secure closure of the appendiceal stump. Two common techniques for this purpose are Hem-o-lok clips (HC) and endoloops (EL), each offering distinct advantages. AIMS: This retrospective study aimed to compare the outcomes of the HC and EL closure techniques. Specifically, the study focused on postoperative complications, hospital stays, and readmission rates. MATERIALS AND METHODS: A retrospective database review was conducted from November 2022 to August 2023. The study compared outcomes, postoperative complications, and the length of hospital stay in 123 patients who underwent appendiceal stump closure with HC and EL at the General Surgery Department of the Turkish Hospital in Doha, Qatar. RESULTS: Among the 123 patients who underwent laparoscopic appendectomy, appendiceal stump closure was performed with HC in 50 patients and EL in 73 patients. Six patients experienced infectious complications associated with the procedure. The hospital stays were similar in both groups (Group HC: 1.3 ± 2 days, Group EL: 1.4 ± 2 days), and there were two readmissions in each group.  Conclusion: The study supports the equivalence of HC and EL closure techniques. Both methods demonstrate comparable postoperative complications, hospital stays, and readmission rates. Surgeons can make informed decisions based on patient profiles and available resources.


Assuntos
Apendicite , Laparoscopia , Humanos , Apendicectomia/métodos , Estudos Retrospectivos , Laparoscopia/métodos , Técnicas de Fechamento de Ferimentos , Complicações Pós-Operatórias/etiologia , Apendicite/cirurgia , Apendicite/complicações
20.
Langenbecks Arch Surg ; 409(1): 84, 2024 Mar 04.
Artigo em Inglês | MEDLINE | ID: mdl-38438562

RESUMO

PURPOSE: Concurrent inguinal hernia can be a challenge for a pediatric surgeon during a laparoscopic appendectomy in children. We aimed to present our approach to inguinal hernias seen during laparoscopic appendectomy. METHODS: In our pediatric surgery clinic between July 2019 and December 2022, the records of patients aged 0-18 who underwent laparoscopic appendectomy were retrospectively investigated. The clinical findings, surgical procedure, and results of intervened inguinal hernia cases during laparoscopic appendectomy were evaluated. RESULTS: Between the study dates, 293 laparoscopic appendectomies were performed in our clinic. Patent processus vaginalis was observed in 5 (1.7%) cases. Laparoscopic hernia repair was performed with the Burnia technique in 2 girls. In one case, the omentum was herniated and adhered to the hernia sac seen during laparoscopy. In another case, swelling in the groin occurred during the introduction of air into the abdomen at the beginning of the operation. Patent processus vaginalis seen in 3 asymptomatic cases was not intervened. There were no postoperative complications or recurrences in the two patients who underwent hernia repair. CONCLUSION: Hernia repair with the Burnia technique might be safely performed in symptomatic inguinal hernia cases seen during laparoscopic appendectomy for early appendicitis.


Assuntos
Apendicite , Hérnia Inguinal , Laparoscopia , Criança , Feminino , Humanos , Hérnia Inguinal/cirurgia , Apendicectomia/efeitos adversos , Apendicite/cirurgia , Estudos Retrospectivos , Laparoscopia/efeitos adversos
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