Analysis of 32 cases of appendectomy after endoscopic retrograde appendicitis therapy in children
10.3760/cma.j.issn.1673-4912.2024.07.008
- VernacularTitle:32例儿童内镜下逆行阑尾炎治疗术后再外科手术切除阑尾病例分析
- Author:
Lu YANG
1
;
Junjie XU
;
Shuai CHEN
;
Shisong ZHANG
;
Yumeng ZHANG
;
Meng SHI
;
Lijun ZHANG
;
Xiuli LIU
;
Xuxia WEI
;
Zhongtao GAI
Author Information
1. 山东大学附属儿童医院（济南市儿童医院）消化科 250022
- Keywords:
Endoscopic retrograde appendicitis therapy;
Children;
Appendicitis;
Surgery
- From:
Chinese Pediatric Emergency Medicine
2024;31(7):518-522
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the related risk factors of surgical appendectomy after endoscopic retrograde appendicitis therapy (ERAT) in children.Methods:From September 2019 to November 2023 at the Children's Hospital Affiliated to Shandong University,the data from all related children with appendectomy after ERAT were analyzed. The general situation and main clinical manifestations of the children were collected. According to the effect of ERAT,the patients were divided into transfer to surgical group and appendicitis recurrence group by the reasons and time of transfer to surgical treatment. The indexes such as ERAT and reoperation process and pathological types of appendix after operation were collected,and the clinical experience was summarized.Results:Among the 242 children who underwent ERAT,32 cases underwent appendectomy again,including 19 males and 13 females,with an average age of（9.16±2.77）years,and the reoperation rate was 13.2%. The clinical manifestation was abdominal pain (32 cases,100.0%),mainly right lower abdominal pain (28 cases,87.5%),and the main duration was less than 3 months (30 cases,93.8%). Abdominal ultrasound or CT before ERAT mainly indicated appendicitis (11 cases,34.4%) and appendicitis complicated with appendiceal calculus (11 cases,34.4%). There were 9 children in transferred to surgical group,of which 5 cases were transferred to surgery because of ERAT intubation failure,and 4 cases were transferred to surgery because of appendix perforation or abscess. Postoperative pathology showed acute suppurative appendicitis in 5 cases and acute gangrenous appendicitis in 4 cases. There were 23 children in appendicitis recurrence group,whose abdominal pain was relieved after ERAT,but their symptoms were repeated after discharge. After clinical evaluation,they were diagnosed as recurrent appendicitis and underwent surgical appendectomy. Most of them were reoperated within 6 months after ERAT (21 cases,91.3%).Postoperative pathology was mainly chronic appendicitis (10 cases,43.5%).Conclusion:Acute suppurative appendicitis and acute gangrenous appendicitis are prone to catheterization or endoscopic failure during ERAT,and there is a high risk of surgical transfer. ERAT may relieve the symptoms of chronic appendicitis in children. If the symptoms are repeated,surgery is still needed to remove the appendix.
