Non-Operative management of acute appendicitis in children

Osman Uzunlu; İncinur Genişol Ataman

Makale detayları

Non-Operative management of acute appendicitis in children

Yazarlar:

Osman Uzunlu | İncinur Genişol Ataman

Yayıncı:

Pamukkale University

Ana Başlıklar:

Cerrahi (Diğer) | Acil Tıp

Dergi:

Pamukkale Tıp Dergisi Vol.16 Issue 4, pp.628-633

Belge Tipi:

Makale

Yayın Tarihi:

1/2023

Belge Dili:

İngilizce

Document ID (Org No.):

2001293137

pISSN:

1308-0865

Anahtar kelimeler:

Özet:

 Purpose: Most studies addressing non-operative management for acute appendicitis have focused on adults, and there are limited data available for children. We aimed to evaluate the results of successful non-operative management in children with acute uncomplicated appendicitis with our additional criteria and find which factors could be affecting the success rate and which cases could be candidates for non-operative management. Materials and methods: A total of 26 patients who were diagnosed with acute uncomplicated appendicitis and received non-operative management were re-evaluated retrospectively. Defining uncomplicated appendicitis was based on the duration of symptoms 24 hours, clinical history, and radiologic findings. The radiologic evaluation was based on ultrasonography and computed tomography. The patients received an intravenous antibiotic combination sulbactamampicillin, gentamicin, clindamycin for five days at the hospital; the treatment was completed after 10 days with an oral antibiotic combination amoxicillinclavulanate, metronidazole. The cases have a follow-up period of up to two years. Results: The mean patient age and follow-up time were 10,423,65 years and 30,155 months, respectively. The mean leukocyte count, C-reactive protein CRP, and appendix diameter values were 15,825,4109L, 20,3833,4mgdL, and 7.871.4 mm on admission. None of the patients had an early failure, complication, or adverse event. Recurrent appendicitis occurred in only one case 4 that was treated by laparoscopic appendectomy during the follow-up. Conclusion: Non-operative management for acute uncomplicated appendicitis in children regarding long-term outcomes with our criteria was satisfactory and initial success rates were excellent.

 Purpose: Most studies addressing non-operative management for acute appendicitis have focused on adults, and there are limited data available for children. We aimed to evaluate the results of successful non-operative management in children with acute uncomplicated appendicitis with our additional criteria and find which factors could be affecting the success rate and which cases could be candidates for non-operative management. Materials and methods: A total of 26 patients who were diagnosed with acute uncomplicated appendicitis and received non-operative management were re-evaluated retrospectively. Defining uncomplicated appendicitis was based on the duration of symptoms 24 hours, clinical history, and radiologic findings. The radiologic evaluation was based on ultrasonography and computed tomography. The patients received an intravenous antibiotic combination sulbactamampicillin, gentamicin, clindamycin for five days at the hospital; the treatment was completed after 10 days with an oral antibiotic combination amoxicillinclavulanate, metronidazole. The cases have a follow-up period of up to two years. Results: The mean patient age and follow-up time were 10,423,65 years and 30,155 months, respectively. The mean leukocyte count, C-reactive protein CRP, and appendix diameter values were 15,825,4109L, 20,3833,4mgdL, and 7.871.4 mm on admission. None of the patients had an early failure, complication, or adverse event. Recurrent appendicitis occurred in only one case 4 that was treated by laparoscopic appendectomy during the follow-up. Conclusion: Non-operative management for acute uncomplicated appendicitis in children regarding long-term outcomes with our criteria was satisfactory and initial success rates were excellent.

 Purpose: Most studies addressing non-operative management for acute appendicitis have focused on adults, and there are limited data available for children. We aimed to evaluate the results of successful non-operative management in children with acute uncomplicated appendicitis with our additional criteria and find which factors could be affecting the success rate and which cases could be candidates for non-operative management. Materials and methods: A total of 26 patients who were diagnosed with acute uncomplicated appendicitis and received non-operative management were re-evaluated retrospectively. Defining uncomplicated appendicitis was based on the duration of symptoms 24 hours, clinical history, and radiologic findings. The radiologic evaluation was based on ultrasonography and computed tomography. The patients received an intravenous antibiotic combination sulbactamampicillin, gentamicin, clindamycin for five days at the hospital; the treatment was completed after 10 days with an oral antibiotic combination amoxicillinclavulanate, metronidazole. The cases have a follow-up period of up to two years. Results: The mean patient age and follow-up time were 10,423,65 years and 30,155 months, respectively. The mean leukocyte count, C-reactive protein CRP, and appendix diameter values were 15,825,4109L, 20,3833,4mgdL, and 7.871.4 mm on admission. None of the patients had an early failure, complication, or adverse event. Recurrent appendicitis occurred in only one case 4 that was treated by laparoscopic appendectomy during the follow-up. Conclusion: Non-operative management for acute uncomplicated appendicitis in children regarding long-term outcomes with our criteria was satisfactory and initial success rates were excellent.

 Amaç: Akut apandisit için ameliyatsız tedaviyi ele alan çoğu çalışma yetişkinlere odaklanmıştır ve çocuklar için sınırlı veri mevcuttur. Akut komplikasyonsuz apandisitli çocuklarda başarılı ameliyatsız yönetimin sonuçlarını ek kriterlerimiz ile değerlendirmeyi ve hangi faktörlerin başarı oranını etkileyebileceğini ve hangi vakaların ameliyatsız tedaviye aday olabileceğini bulmayı amaçladık. Gereç ve yöntem: Akut komplikasyonsuz apandisit tanısı alan ve ameliyatsız tedavi uygulanan toplam 26 hasta retrospektif olarak yeniden değerlendirildi. Komplike olmayan apandisit tanımlaması semptomların süresine 24 saat, klinik öyküye ve radyolojik bulgulara dayanıyordu. Radyolojik değerlendirme ultrasonografi ve bilgisayarlı tomografi ile yapıldı. Hastalara hastanede beş gün intravenöz antibiyotik kombinasyonu sulbaktamampisilin, gentamisin, klindamisin verildi; tedavi oral antibiyotik kombinasyonu amoksisilinklavulanat, metronidazol ile 10 güne tamamlandı. Olguların ortalama takip süresi iki yıldı. Bulgular: Ortalama hasta yaşı ve takip süresi sırasıyla 10,423,65 yıl ve 30,155 aydı. Başvuru anındaki ortalama lökosit sayısı, C-reaktif protein CRP ve apendiks çapı değerleri 15,825,4109L, 20,3833,4mgdL ve 7,871,4 mm idi. Hastaların hiçbirinde erken başarısızlık, komplikasyon veya yan etki görülmedi. İzlemde sadece bir olguda 4 tekrarlayan apandisit gelişti ve laparoskopik apendektomi ile tedavi edildi. Sonuç: Çocuklarda akut komplike olmayan apandisitin ameliyatsız yönetimi, kriterlerimize göre uzun vadeli sonuçlara göre tatmin ediciydi ve başlangıç başarı oranları mükemmeldi.

Makale detayları

Non-Operative management of acute appendicitis in children

Yazarlar:

Osman Uzunlu | İncinur Genişol Ataman

Yayıncı:

Pamukkale University

Ana Başlıklar:

Cerrahi (Diğer) | Acil Tıp

Dergi:

Pamukkale Tıp Dergisi Vol.16 Issue 4, pp.628-633

Belge Tipi:

Makale

Yayın Tarihi:

1/2023

Belge Dili:

İngilizce

Document ID (Org No.):

2001293137

pISSN:

1308-0865

Acute appendicitis

appendectomy

children

conservative treatment

non-operative managementAkut apandisit

apandisit

çocuk

konservatif tedavi

ameliyatsız tedavi

Sayı

Makale detayları

Yazarlar: Osman Uzunlu | İncinur Genişol Ataman

Yayıncı: Pamukkale University

Ana Başlıklar: Cerrahi (Diğer) | Acil Tıp

Dergi: Pamukkale Tıp Dergisi Vol.16 Issue 4, pp.628-633

Belge Tipi: Makale

Yayın Tarihi: 1/2023

Belge Dili: İngilizce

Document ID (Org No.): 2001293137

pISSN: 1308-0865

Sayı

Yazarlar:

Osman Uzunlu | İncinur Genişol Ataman

Yayıncı:

Pamukkale University

Ana Başlıklar:

Cerrahi (Diğer) | Acil Tıp

Dergi:

Pamukkale Tıp Dergisi Vol.16 Issue 4, pp.628-633

Belge Tipi:

Makale

Yayın Tarihi:

1/2023

Belge Dili:

İngilizce

Document ID (Org No.):

2001293137

pISSN:

1308-0865