지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 저널정보
- 대한외과학회 Annals of Surgical Treatment and Research Annals of Surgical Treatment and Research Vol.97 No.2
- 발행연도
- 2019.8
- 수록면
- 103 - 111 (9page)
이용수
초록· 키워드
오류제보하기
Purpose: Surgeons may be uncertain about the optimal timing of appendectomy to decrease complications, especially for complicated appendicitis. The aim of the study was to compare clinical outcomes between early and late surgery for complicated appendicitis.
Methods: A prospectively maintained database of complicated appendicitis was queried. Elective interval surgery (EIS) group and early surgery (ES) were matched with propensity score and marked with a prefix ‘p.’ Patient characteristics and surgical outcomes were compared.
Results: The propensity score-matched EIS group had a lower chance to underwent ileo-cecectomy or right hemicolectomy (1.5% vs. 6.9%, P = 0.031), a tendency of lower rate of postoperative complication (6.9% vs. 13.7%, P = 0.067), a lower rate of wound infection (1.5% vs. 8.4%, P = 0.010), and shorter postoperative hospital stay (3.72 days vs. 5.82 days, P ＜ 0.001) than the propensity score-matched ES group. Multivariate analysis showed that delayed surgery for more than 48 hours or urgent surgery due to failure of EIS and open conversion were independent risk factors for postoperative complications (P = 0.001 and P = 0.025, respectively). In subgroup analysis, high American Society of Anesthesiologists physical status classification and distant abscess or generalized ascites in initial CT increased the risk of failure of EIS.
Conclusion: EIS can be a useful option for selected adult patients with complicated appendicitis.
Methods: A prospectively maintained database of complicated appendicitis was queried. Elective interval surgery (EIS) group and early surgery (ES) were matched with propensity score and marked with a prefix ‘p.’ Patient characteristics and surgical outcomes were compared.
Results: The propensity score-matched EIS group had a lower chance to underwent ileo-cecectomy or right hemicolectomy (1.5% vs. 6.9%, P = 0.031), a tendency of lower rate of postoperative complication (6.9% vs. 13.7%, P = 0.067), a lower rate of wound infection (1.5% vs. 8.4%, P = 0.010), and shorter postoperative hospital stay (3.72 days vs. 5.82 days, P ＜ 0.001) than the propensity score-matched ES group. Multivariate analysis showed that delayed surgery for more than 48 hours or urgent surgery due to failure of EIS and open conversion were independent risk factors for postoperative complications (P = 0.001 and P = 0.025, respectively). In subgroup analysis, high American Society of Anesthesiologists physical status classification and distant abscess or generalized ascites in initial CT increased the risk of failure of EIS.
Conclusion: EIS can be a useful option for selected adult patients with complicated appendicitis.
목차
INTRODUCTION
METHODS
RESULTS
DISCUSSION
REFERENCES
참고문헌 (30)
참고문헌 신청
Owings MF / 1998 / Ambulatory and inpatient procedures in the United States, 1996 / Vital Health Stat 13(139):1~119
Karp MP / 1986 / The avoidable excesses in the management of perforated appendicitis in children / J Pediatr Surg 21:506~510
Andersson RE / 2007 / Nonsurgical treatment of appendiceal abscess or phlegmon : a systematic review and metaanalysis / Ann Surg 246:741~748
Ingraham AM / 2010 / Effect of delay to operation on outcomes in adults with acute appendicitis / Arch Surg 145:886~892
Maru Kim / 2016 / Effect of surgical timing and outcomes for appendicitis severity / 대한외과학회지 91(2):85~89
Karp MP / 1986 / The avoidable excesses in the management of perforated appendicitis in children / J Pediatr Surg 21:506~510
Andersson RE / 2007 / Nonsurgical treatment of appendiceal abscess or phlegmon : a systematic review and metaanalysis / Ann Surg 246:741~748
Ingraham AM / 2010 / Effect of delay to operation on outcomes in adults with acute appendicitis / Arch Surg 145:886~892
Maru Kim / 2016 / Effect of surgical timing and outcomes for appendicitis severity / 대한외과학회지 91(2):85~89
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UCI(KEPA) : I410-ECN-0101-2019-514-000942485