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1

Laparoscopic Management of Appendicular Abscess (Clinical Observation)

100%

Tutchenko M., Svitlychnyi E., Wojcicka K., Shavlovskyi O.

Polish Journal of Surgery

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2015

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vol. 86

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issue 5

235-237

EN

This article presents the diagnostics and laparoscopic management of appendicular abscess of 66 y.o. woman operated 3 weeks after the disease onset. The patient underwent surgery successfully. Purulent septic post-operative complications were not demonstrated. That confirms the benefits of minimally invasive surgery

2

Laparoscopic Appendectomy as an Alternative to Conventional Procedure – Results in our own Material

100%

Merenda M., Litarski A., Kabziński P., Janczak D.

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vol. 85

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issue 6

323-328

EN

Appendectomies are the most common surgical procedures performed in the emergency surgery setting. Since more than one decade laparoscopic appendectomy appeared as an alternative procedure to commonly used conventional appendectomy as a recognized method of treatment of acute appendicitis. Despite multiple papers and studies comparing these techniques, still no clear indications and eligibility criteria exist for either of them. The aim of the study was to evaluate results of treatment of acute appendicitis using the laparoscopic method versus the conventional appendectomy, basing on parameters affecting treatment results and costs, such as duration of hospitalization, complications, use of medications. Material and methods. The analysis included patients who underwent surgical treatment for acute appendicitis at the Department of Surgery of 4th Military Clinical Hospital in Wrocław between 2006 and 2012. Since 2006, 128 laparoscopic appendectomies (group 1) were performed, while 189 patients underwent conventional procedure during this time (including 11 who underwent a diagnostic laparoscopy - group 2). The study was based on retrospective analysis of medical records of patients. Treatment results were evaluated basing on the following parameters: duration of hospitalization, amount of used analgesics, duration and type of antibiotic therapy, peri- and postoperative complications. Results and conclusions. Results obtained at our Clinic, similar to results obtained at other sites, warrant use of laparoscopic appendectomy. Use of minimally invasive techniques provides better treatment results, mainly with regard to shorter duration of hospitalization, lower use of antibiotics and analgesics, which also contributes to lower overall treatment costs.

3

Primary Adenocarcinoma of the Appendix – A Case Report

80%

Pasternak A., Pach R., Szura M., Solecki R., Tomaszewski K. A., Szczepański W., Matyja A., Kulig J.

Polish Journal of Surgery

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2015

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vol. 86

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issue 7

333-336

EN

Primary adenocarcinoma of the vermiform appendix is a rare clinical condition. It usually presents as an acute abdominal process or as a mass in the right lower quadrant. The gross pathologic and microscopic characteristics of this disease are the same as for colon carcinoma and carry a serious prognosis. We report a case of a 64-year old male patient presenting symptoms of acute appendicitis. The patient underwent laparoscopic appendectomy that revealed a severely inflamed appendix. Histopathological examination has shown that it was a poorly differentiated, high grade adenocarcinoma invading the periappendicular fat. According to the histopathological findings, a right hemicolectomy was further advised and performed. Right hemicolectomy is the generally recommended method of treatment for invasive adenocarcinoma of the appendix

4

Results of Laparoscopic Appendectomies Performed with the Use of Titanium Clips for Closure of the Appendicular Stump

80%

Strzałka M., Matyja M., Rembiasz K.

Polish Journal of Surgery

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2015

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vol. 86

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issue 9

418-421

EN

Nowadays laparoscopy is used frequently not only in elective surgery but also in abdominal emergencies, including acute appendicitis. There are several techniques used to close the appendicular stump during laparoscopic appendectomy. The aim of the study was to present the results of minimally invasive appendectomies performed with the use of titanium clips. material and methods. Patients operated on laparoscopically for acute appendicitis with the application of titanium clips between October 2012 and December 2013 were included in the study. We reviewed retrospectively patients` data including: age, sex, duration of the surgical procedure and hospital stay, mortality, intraoperative and postoperative complication rates. Results. There were 93 patients (mean age=33.8 years, SD=15.23) in the analyzed group, including 60 men (mean age=33.5 years, SD= 15.07) and 33 women (mean age=33.9 years SD=15.26). The aver-age duration of the surgical procedure was 66 min (SD= 33.15). The average length of hospital stay was 3.38 days (SD=1.62). No intraoperative complications were observed in the analyzed group. Post-operative complication rate was low (6 cases, 6.5%). No mortality was observed. Conclusions. Laparoscopic appendectomy with the application of titanium clips for closure of the appendicular stump is safe, associated with low complication rates and should be considered as a routine technique in everyday surgical practice.

5

Surgical treatment of acute appendicitis in older patients

80%

Dowgiałło-Wnukiewicz N., Kozera P., Wójcik W., Lech P., Rymkiewicz P., Michalik M.

Polish Journal of Surgery

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2019

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vol. 91(2)

12-15

EN

Introduction: Acute appendicitis (AA) is the most common indication for emergency surgery and it occurs more often in children and young adults than in patients of advanced age. AA in older patients is a challenging surgical problem because of its atypical presentation. This study was performed to determine whether the age of a patient impacts the outcomes and whether laparoscopic appendectomy (LA) is a feasible method for treatment of patients > 65 years. Material and methods: We performed a retrospective study of 355 patients with AA who were admitted to the Department of General, Minimally Invasive and Elderly Surgery in Olsztyn from 2014 to 2017. The patients were divided into three age groups: 18 to 40, 41 to 65 and >65 years. The histopathological diagnoses were divided into three types: simple AA, phlegmonous AA, and gangrenous AA. Results. LA was performed in 96% of young adults and in 67% of older patients. The patients older than 65 years had higher preoperative white blood cell counts, higher C-reactive protein (CRP) levels and had a longer length of stay (LOS) than younger patients (P=0.05, P=0.03, and P=0.03, respectively). We found a positive correlation among the CRP levels, open appendectomy (OA), and gangrenous appendicitis. Conclusions: Patients older than 65 years more frequently underwent OA than LA, had higher preoperative CRP levels and had a longer LOS than younger patients. Higher CRP levels were associated with a greater risk of gangrenous appendicitis. LA is a safe and feasible treatment method for patients older than 65 years.

6

Laparosocopic Appendectomy, Cost-Effectiveness of Three Different Techniques Used to Close the Appendix Stump

80%

Matyja M., Strzałka M., Rembiasz K.

Polish Journal of Surgery

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2015

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vol. 87

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issue 12

634-637

EN

It is generally agreed that laparoscopic appendectomy is a valuable operative method. The aim of the study was to evaluate cost-effectiveness of three different techniques used to close the appendix stump. Material and methods. We conducted a retrospective study that compared three groups of patients who were operated on laparoscopically for acute appendicitis in 2013 at our institution. We used an endoscopic clip to close the appendix stump in the first group (n=20), endoscopic stapler was applied in the second group (n=20), and in the third group of patients the appendix base was closed with a laparoscopic suture (n=20). These groups were matched by age, sex and BMI. Results. The average operative cost was the highest in the second group. Cost of the laparoscopic appendectomy with the application of the endoscopic clip was significantly lower (first group) and comparable to the third group. Observed differences in total hospitalization costs were associated only with the chosen appendix stump closure technique. Conclusions. Clip closure of the appendix base is an easy and cost-effective procedure. The laparoscopic suture technique is the cheapest but technically demanding. According to our experience endoscopic stapler may be useful in some cases, although it is the most expensive method.

7

Laparosocopic appendectomy, cost-effectiveness of three different techniques used to close the appendix stump

80%

Matyja M., Strzałka M., Rembiasz K.

Polish Journal of Surgery

|

2015

|

vol. 87(12)

634-637

EN

It is generally agreed that laparoscopic appendectomy is a valuable operative method. The aim of the study was to evaluate cost-effectiveness of three different techniques used to close the appendix stump. Material and methods. We conducted a retrospective study that compared three groups of patients who were operated on laparoscopically for acute appendicitis in 2013 at our institution. We used an endoscopic clip to close the appendix stump in the first group (n=20), endoscopic stapler was applied in the second group (n=20), and in the third group of patients the appendix base was closed with a laparoscopic suture (n=20). These groups were matched by age, sex and BMI. Results. The average operative cost was the highest in the second group. Cost of the laparoscopic appendectomy with the application of the endoscopic clip was significantly lower (first group) and comparable to the third group. Observed differences in total hospitalization costs were associated only with the chosen appendix stump closure technique. Conclusions. Clip closure of the appendix base is an easy and cost-effective procedure. The laparoscopic suture technique is the cheapest but technically demanding. According to our experience endoscopic stapler may be useful in some cases, although it is the most expensive method.

8

Risk of complications and 30-day mortality after laparoscopic and open appendectomy in a Danish region, 1998-2007; a population-based study of 18,426 patients

70%

Bregendahl S., Nørgaard M., Laurberg S., Jepsen P.

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vol. 85

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issue 7

395-400

EN

Acute appendicitis is the most common abdominal surgical emergency, but population-based data on the risk of complications after laparoscopic appendectomy (LA) and open appendectomy (OA) are scarce. The aim of the study was to describe the risk of complications and mortality after appendectomy for acute appendicitis during a 10-year period, and to compare outcomes after LA and OA. Material and methods. Using population-based registry data, we conducted a historical cohort study in a Danish region (population 2,000,000) including all patients who underwent appendectomy for acute appendicitis during the period of 1998-2007. We used logistic regression to compare the risk of complications and 30-day mortality between LA and OA, adjusting for gender, age, severity of appendicitis, time of surgery, and calendar year. Analyses were stratified for severity of appendicitis and time period. Results. We included 18,426 patients. From 1998 to 2007 the use of LA rose from 12% to 61%, while the risk of surgically-treated complications fell from 5.7% to 3.2%, the risk of intra-abdominal infections fell from 2.4% to 1.1% and 30-day mortality fell from 0.30% to 0.23%. LA was associated with a lower risk of surgically-treated complications (adjusted odds ratio for LA vs. OA=0.70 (95% CI, 0.57-0.85), intraabdominal infections (OR=0.74 [95% CI, 0.55-0.99]) and mortality (OR=0.48 [95% CI, 0.18-1.30]). LA was safer than OA for simple and complicated appendicitis throughout the study period. Conclusions. Risk of complications and 30-day mortality decreased in Denmark between 1998 and 2007 concurrently with implementation of LA. The risk of complications was lower after LA than after OA

Refine search results

Laparoscopic Management of Appendicular Abscess (Clinical Observation)

Laparoscopic Appendectomy as an Alternative to Conventional Procedure – Results in our own Material

Primary Adenocarcinoma of the Appendix – A Case Report

Results of Laparoscopic Appendectomies Performed with the Use of Titanium Clips for Closure of the Appendicular Stump

Surgical treatment of acute appendicitis in older patients

Laparosocopic Appendectomy, Cost-Effectiveness of Three Different Techniques Used to Close the Appendix Stump

Laparosocopic appendectomy, cost-effectiveness of three different techniques used to close the appendix stump

Risk of complications and 30-day mortality after laparoscopic and open appendectomy in a Danish region, 1998-2007; a population-based study of 18,426 patients