The analysis of delayed appendectomy in the treatment of patients with acute nonperforated appendicitis

doi:10.3877/cma.j.issn.2095-3224.2017.04.013

Abstract

Abstract:

Objective

We aimed to evaluate the safety and feasibility of delayed appendectomy in the treatment of acute, nonperforated appendicitis.

Methods

We collected the patients who underwent an appendectomy for acute, nonperforated appendicitis between January 2004 and February 2013in the First People′s Hospital of North Forest Region. Patients were divided into 2 groups for comparison: an immediate group (those who were moved to an operating room within 24 hours after hospital arrival) and a delayed group (those within 24 to 48 hours after hospital arrival). The end points were operative time, perforation rate, complication rate, readmission rate and length of hospital stay.

Results

Of 902 patients, 671 (74.3%) underwent immediate operation within 24 hours after hospital arrival, whereas 231 (25.7%) underwent delayed operation within 24 to 48 hours. There were no significant differences in operative time, perforation, postoperative complications, and readmission between the 2 groups. Length of hospital stay was significantly greater was also greater in the delayed group than in the immediate group (t=7.34; P=0.02).

Conclusion

Delayed appendectomy is safe for patients with acute nonperforated appendicitis.

Key words: Appendicitis, Appendectomy, Immediate appendectomy, Delayed appendectomy

Yingxin Wang, Chuanli Peng. The analysis of delayed appendectomy in the treatment of patients with acute nonperforated appendicitis[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2017, 06(04): 327-329.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhjzcjbdzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-3224.2017.04.013

https://zhjzcjbdzzz.cma-cmc.com.cn/EN/Y2017/V06/I04/327

Figures/Tables 2

References 9

[1]	赵轶国，印建中. 应用抗生素治疗急性单纯性阑尾炎的策略及其价值[J]. 北京大学学报(医学版), 2014, 46(05):715-719.
[2]	Berry J Jr, Malt RA. Appendicitis near its centenary[J]. Ann Surg, 1984,200(5):567–575.
[3]	Abou-Nukta F, Bakhos C, Arroyo K, et al. Effects of delaying appendectomy for acute appendicitis for 12 to 24 hours[J]. Arch Surg,2006,141(5):504–506; discussion 506–507.
[4]	Omundsen M, Dennett E. Delay to appendicectomy and associated morbidity: a retrospective review[J]. ANZ J Surg, 2006, 76(3):153–155.
[5]	Ingraham AM, Cohen ME, Bilimoria KY, et al. Effect of delay to operation on outcomes in adults with acute appendicitis[J]. Arch Surg,2010,145(9):886–892.
[6]	Bufo AJ, Shah RS, Li MH, et al. Interval appendectomy for perforated appendicitis in children[J]. J Laparoendosc Adv Surg Tech A,1998,8(4):209–214.
[7]	Mazziotti M, Marley E, Winthrop A, et al. Histopathologic analysis of interval appendectomy specimens: support for the role of interval appendectomy[J]. J Pediatr Surg,1997,32(6):806–809.
[8]	Hansson J, K¨orner U, Khorram-Manesh A, et al. Randomized clinical trial of antibiotic therapy versus appendicectomy as primary treatment of acute appendicitis in unselected patients[J]. Br J Surg, 2009, 96(5):473-481.
[9]	Styrud J, Eriksson S, Nilsson I, et al. Appendectomy versus antibiotic treatment in acute appendicitis. A prospective multicenter randomized controlled trial[J]. World J Surg, 2006, 30(6):1033–1037.

一般资料		延迟手术组	急诊手术组	t/Χ²值	P值
年龄（±s，岁）		31.8±14.9	30.4±12.2	0.670	0.14
性别（例，%）				0.300	0.58
	男	126（54.6）	380（56.7）
	女	105（45.4）	291（43.3）
BMI（±s，kg/m²）		21.5±4.1	21.1±4.1	0.910	0.07
ASA评分（分）				0.540	0.34
	1	59（25.6）	179（27.3）
	2	168（72.7）	461（70.9）
	3	3（1.3）	9（1.4）
	4	0（0）	1（0.2）
	5	1（0.4）	1（0.2）
白细胞计数（±s，10⁹ /dL）		13.9±4.4	14.1±4.3	0.690	0.49
体温（±s，℃）		37.0±0.4	36.6±0.5	8.230	0.01

一般资料		延迟手术组	急诊手术组	t/Χ²值	P值
年龄（±s，岁）		31.8±14.9	30.4±12.2	0.670	0.14
性别（例，%）				0.300	0.58
	男	126（54.6）	380（56.7）
	女	105（45.4）	291（43.3）
BMI（±s，kg/m²）		21.5±4.1	21.1±4.1	0.910	0.07
ASA评分（分）				0.540	0.34
	1	59（25.6）	179（27.3）
	2	168（72.7）	461（70.9）
	3	3（1.3）	9（1.4）
	4	0（0）	1（0.2）
	5	1（0.4）	1（0.2）
白细胞计数（±s，10⁹ /dL）		13.9±4.4	14.1±4.3	0.690	0.49
体温（±s，℃）		37.0±0.4	36.6±0.5	8.230	0.01

围手术期病例资料		延迟手术组	急诊手术组	t/Χ²值	P值
手术时间（±s，分）		49.1±20.6	48.8±22.4	0.560	0.82
阑尾穿孔（例，%）				0.080	0.78
	未穿孔	203（87.9）	585（87.2）
	穿孔	28（12.1）	86（12.8）
术后并发症（例，%）				0.003	0.96
全部并发症		14（6.0）	40（6.0）
	切口感染	9（3.9）	27（4.0）
	腹腔感染	4（1.5）	11（1.7）
	其它	1（0.6）	2（0.2）
二次入院（例，%）		5（2.2）	16（2.5）	0.037	0.85
总住院时间（±s，天）		8.1±1.6	8.7±1.8	7.340	0.02
术后住院时间（±s，天）		6.9±1.7	7.0±1.9	0.610	0.65

围手术期病例资料		延迟手术组	急诊手术组	t/Χ²值	P值
手术时间（±s，分）		49.1±20.6	48.8±22.4	0.560	0.82
阑尾穿孔（例，%）				0.080	0.78
	未穿孔	203（87.9）	585（87.2）
	穿孔	28（12.1）	86（12.8）
术后并发症（例，%）				0.003	0.96
全部并发症		14（6.0）	40（6.0）
	切口感染	9（3.9）	27（4.0）
	腹腔感染	4（1.5）	11（1.7）
	其它	1（0.6）	2（0.2）
二次入院（例，%）		5（2.2）	16（2.5）	0.037	0.85
总住院时间（±s，天）		8.1±1.6	8.7±1.8	7.340	0.02
术后住院时间（±s，天）		6.9±1.7	7.0±1.9	0.610	0.65

[1]	Jinhong Gao, Shaolong Hao, Yong Liu, Yibing Weng, Wei Han, Guan Wang, Teng Zhang, Peng Liu, Lei Zhang, Xinyu Zhao. Comparison of the therapeutic effects of indomethacin suppository and lornoxicam application before laparoscopic appendectomy [J]. Chinese Archives of General Surgery(Electronic Edition), 2023, 17(04): 293-297.
[2]	Yishan Zhan, Yourong Zhu, Shouhua Zhang, Qiang Tao. Progress of prediction models related to acute appendicitis [J]. Chinese Archives of General Surgery(Electronic Edition), 2023, 17(02): 151-154.
[3]	Chuang Li, Xiangjie Lin, Jingwen Fan, Xuefei Yang. Clinical application of endoscopic retrograde appendicitis therapy: A scoping review [J]. Chinese Archives of General Surgery(Electronic Edition), 2022, 16(05): 366-370.
[4]	Jinhong Gao, Shaolong Hao, Yong Liu, Wei Han, Yibing Weng. Application of perioperative pain management under the concept of enhanced recovery after surgery in ambulatory laparoscopic appendectomy [J]. Chinese Archives of General Surgery(Electronic Edition), 2022, 16(02): 146-150.
[5]	Guogang Wu, Aili Jin, Shouliang Cai, Zhaorun Liu, Mei Leng, Yiying Jin, Ruoyu Shi, Fuxin Wang. Laparoscopic surgery for acute appendicitis with an onset time more than 72 hours [J]. Chinese Archives of General Surgery(Electronic Edition), 2020, 14(06): 446-448.
[6]	Junjie Liu, Jinming Zhao, Hao Gu, Zhiqiang Zhu. Direct clamping vs suture embedding of the appendiceal stump in laparoscopic appendectomy: A systematic review and Meta-analysis [J]. Chinese Archives of General Surgery(Electronic Edition), 2020, 14(04): 314-320.
[7]	Kai Li, Lin Chen, Han Xiang, Huaidong Su, Wei Zhang. Clinical application of a U-shaped memory alloy wire in transumbilical single-port laparoscopic appendectomy [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(01): 15-15.
[8]	Shusen Feng, Dongcheng Zhang, Qi Guo, Haolu Zhang, Kuo Chen. Clinical effect of laparoscopic appendectomy on acute appendicitis and its influence on inflammatory factors [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2023, 17(04): 447-450.
[9]	Jinhong Gao, Shaolong Hao, Yong Liu, Yibing Weng, Wei Han, Guan Wang, Teng Zhang, Peng Liu, Lei Zhang, Xinyu Zhao, Siyi Wang. Effect of indomethacin suppository and lornoxicam on immune function before laparoscopic appendectomy [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2023, 17(01): 76-79.
[10]	Jinshui Chen, Xiaolu Zhu, Yaping Xu, Tiehu Wang, Song Yang, Luqi Yang, Jun Tan, Kaifu Zheng, Zhengping Li. Feasibility analysis of laparoscopic totally extraperitoneal hernia repair for the right inguinal hernia with history of appendectomy [J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2023, 17(05): 544-550.
[11]	Jixin Zhang, Junhong Hu, Shuang Xie, Zuyin Wu, Chunxu Zhang. Analysis of feasibility and short-term efficacy of transvaginal single-port laparoscopic appendectomy [J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2023, 12(06): 460-465.
[12]	Yuantao Wu, Feng Li, Bin Yang, Jia'nan Tan, Guangyu Zhong, Lin Zhong, Shengning Zhou. A multicenter retrospective analysis of single-port versus conventional three-port laparoscopic appendectomy for acute appendicitis: a propensity score matching study [J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2023, 12(01): 64-69.
[13]	Liying Tao, Hongguang Wang, Xiang Guo, Qingmei Guo. The diagnostic and therapeutic value of SpyGlass DS assisted endoscopic retrograde appendicitis therapy [J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2020, 09(06): 625-629.
[14]	Mingjie Li, Xiong Wang. Effect of local anesthesia on pain after laparoscopic appendectomy [J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2023, 13(04): 266-270.
[15]	lin Liu, Shuquan Duan, Xianmei Meng, Tong Dang. Meta-analysis of the efficacy comparison of retrograde endoscopic appendicitis in the treatment of acute non-perforated appendicitis [J]. Chinese Journal of Gastrointestinal Endoscopy(Electronic Edition), 2021, 08(01): 18-23.

Please choose a citation manager

Content to export