Appendicitis ; complications ; Humans ; Infant, Newborn ; Intussusception ; complications

PURPOSE: Recently, single incision laparoscopic surgery (SILS) has been studied for its being less invasive surgery and having cosmetic improvement. We investigated the application of SILS for an appendectomy (SILS-A) in cases of complicated appendicitis and compare it with a conventional laparoscopic appendectomy (C-LA). METHODS: This study involved a total of 40 patients who underwent C-LA or SILS-A in patients with complicated appendicitis; 25 patients received a C-LA, and the other 15 patients received a SILS-A. The clinical outcomes and cosmetic results were compared between the groups. RESULTS: The SILS-A procedures were performed successfully in patients with complicated appendicitis, but 6 patients who underwent SILS-A needed an additional port for dissection and drainage. Clinical outcomes and postoperative complications were similar in both study groups. The SILS-A group showed significantly higher numbers of pain control than the C-LA group, and the one port SLLS-A group showed significantly better cosmetic result than the C-LA group. CONCLUSION: SILS-A is technically feasible and safe in patients with complicated appendicitis. However, SILS-A has more postoperative pain than C-LA, and more active pain control should be considered for patients undergoing SILS-A.
Appendectomy ; Appendicitis ; Cosmetics ; Drainage ; Humans ; Laparoscopy ; Pain, Postoperative ; Postoperative Complications

PURPOSE: In recent years, single-port laparoscopic appendectomy (SPLA) has been gaining in popularity and there have been many reports on the results of SPLA. The purpose of this study is to investigate feasibility, safety, and cosmetic satisfaction with SPLA in treatment of perforated appendicitis. METHODS: From September 2012 to March 2015, 227 patients underwent SPLA at Damsoyu hospital. The patients were divided into the simple and gangrenous appendicitis group (the S & G group) and the perforated appendicitis group (the P group). Operation time, hospital stay, drain insertion rate, surgical complication, and cosmetic satisfaction were evaluated. RESULTS: A total of 227 patients consisted of 32 patients in the P group and 195 patients in the S & G group. There were no significant differences in the demographic data of the patients. The operation time and hospital stay were significantly longer in the P group (p=0.002 and p<0.0001, respectively). The rate of drain insertion was also higher in the P group (p=0.0002). However, no differences in postoperative complications (p=0.281) and cosmetic satisfaction (p=0.090) were observed between the two groups. CONCLUSION: SPLA for perforated appendicitis is a feasible, safe, and cosmetically acceptable procedure. However, longer operation time and hospital stay and higher drain insertion rate should be considered for patients undergoing SPLA for perforated appendicitis.
Appendectomy ; Appendicitis* ; Humans ; Laparoscopy* ; Length of Stay ; Postoperative Complications

BACKGROUND: It is controversial whether the delay of surgery for acute appendicitis by physician results in higher morbidity. Our present study explores this problem of physician delay on the postoperative outcome of patients with acute appendicitis. MATERIAL AND METHODS: Among 432 patients admitted for the presumptive diagnosis of acute appendicitis between Jan., 1995 and Dec., 1997, 358 patients with pathologically proven acute appendicits were analyzed. Physician delay from the hospital admission to the surgery was evaluated in relation to the stage of the disease at operation and postoperative outcome. RESULTS: Postoperative complications occurred signifficantly higher in advanced appendicitis group, than in simple appendicitis group. Postoperative oral consumption started significantly later and hospital days are significantly prolonged in those group. Both patient and physician delays significantly affect the stage of the disease. The finding that physician delay correlated with the stage, however, was denied by multivariate analysis. CONCLUSION: On the contrary to the patient delay, physician delay does not affect the stage of the acute appendicitis nor lead to increased incidence of postoperative complication. Physician delay to clarify the diagnosis is a reasonable strategy and it does not affect the outcome adversely.
Appendicitis* ; Diagnosis ; Humans ; Incidence ; Multivariate Analysis ; Postoperative Complications

PURPOSE: With varied reports on the impact of time to appendectomy on clinical outcomes, the purpose of this study was to determine the effect of preoperative in-hospital delay on the outcome for patients with acute appendicitis. METHODS: A retrospective review of 1,076 patients who had undergone an appendectomy between January 2010 and December 2013 was conducted. RESULTS: The outcomes of surgery and the pathologic findings were analyzed according to elapsed time. The overall elapsed time from onset of symptoms to surgery was positively associated with advanced pathology, increased number of complications, and prolonged hospital stay. In-hospital elapsed time was not associated with any advanced pathology (P = 0.52), increased number of postoperative complications (P = 0.14), or prolonged hospital stay (P = 0.24). However, the complication rate was increased when the in-hospital elapsed time exceeded 18 hours. CONCLUSION: Advanced pathology and postoperative complication rate were associated with overall elapsed time from symptom onset to surgery rather than in-hospital elapse time. Therefore, a short-term delay of an appendectomy should be acceptable.
Appendectomy ; Appendicitis ; Humans ; Length of Stay ; Pathology ; Postoperative Complications ; Retrospective Studies

Recent reports have demonstrated a negative association between appendectomy and ulcerative colitis. Many retrospective studies have shown that appendectomy appears to be protective against ulcerative colitis. Although the function of appendix is not known, all these studies have suggested that alterations in mucosal immune responses leading to appendicitis or resulting from appendectomy may negatively affect the pathogenic mechanisms of ulcerative colitis. Herein, we report a 45-year-old man who was diagnosed as severe ulcerative colitis 2 years ago. Colonoscopy revealed a feature of pancolitis. He has been treated with several courses of corticosteroids over 2 years. However, dosage of steroid was not tappered down because of the recurrence of symptoms. He was admitted with a diagnosis of acute appendicitis, and underwent appendectomy. Two months after the appendectomy, clinical symptoms and colonoscopic findings improved gradually. Two years after the appendectomy, the patient improved without the recurrences of symptoms, and is stably treated with sulfasalazine alone.
*Appendectomy ; Appendicitis/complications/*surgery ; Colitis, Ulcerative/complications/*physiopathology ; Humans ; Male ; Middle Aged

Acute appendicitis is a common disease, in general, but is rare in the elderly. This report is a clinical review of 148 patients over the age of 60 who, due to acute appendicitis, underwent appendectomies at the Department of General Surgery of Saint Columban Hospital from January 1993 to December 1995. The results are as follows: 1) The overall percentage of the patients over the age of 60 was about 16.4%. 2) The male to female ratio was 1:1.6. 3) The perforation rate was 33.1%. 4) The mean duration of symptoms were 2 days in non-perforated and 4.5 days in perforated appendicitis. 5) The chief complaints were pain (86.5%) and tenderness (88.5%) on right lower quadrant. 6) This disease occurred most frequently in spring and summer. 7) The highest incidence of leukocyte count was 10,000~15,000 per cubic mm of blood (50%). 8) The most frequent postoperative complication was wound infection as 14.2%. 9) sixty-seven cases (45.3%) were accompanied by concomitant disease, the most frequent being hypertention (14.9%). 10) The mean numbers of hospital days were 7.5 in non-perforated and 14 in perforated appendicitis.
Aged ; Appendectomy ; Appendicitis* ; Female ; Humans ; Incidence ; Leukocyte Count ; Male ; Postoperative Complications ; Saints ; Wound Infection

PURPOSE: The objective of this retrospective study is to evaluate the practical feasibility and safety of applying hem-o-lok clips for the closure of the appendiceal stump in complicated appendicitis. METHODS: From January 2009 to April 2010, 267 patients who underwent laparoscopic appendectomies at the Pusan National University Yangsan Hospital were included in this study. Of these patients, 161 were diagnosed by computed tomography as having complicated acute appendicitis. In 107 patients, the appendiceal stump was closed with hem-o-lok clips, whereas in the remaining 160 patients, it was closed with endoloops. These two groups were compared for clinicopathologic data and procedural cost-effectiveness. RESULTS: No significant differences were found between the two groups in terms of age, sex, hospital stay, or blood loss. Furthermore, postoperative complications were similar and highly acceptable in both groups. However, operation times were significantly shorter and hospital cost was lower for the hem-o-lok group. CONCLUSION: The hem-o-lok clips has advantages such as simplicity of application, a shorter operation time, and lower hospital cost when used as a means of securing the base of the appendix in relation to the endoloop procedure.
Appendectomy ; Appendicitis ; Appendix ; Hospital Costs ; Humans ; Length of Stay ; Postoperative Complications ; Retrospective Studies

PURPOSE: The laparoscopic appendectomy has become popular for the treatment of acute appendicitis. A single-incision laparoscopic appendectomy offers better cosmesis. We present the results of single-incision laparoscopic appendectomies in our hospital as initial experience. METHODS: A single-incision laparoscopic appendectomy was performed in 75 patients at The Catholic University of Korea, Bucheon St. Mary's hospital. The operating time, operation type, hospital stay, surgical morbidities, and body mass index were compared. RESULTS: This retrospective study revealed equal operation times in both the suppurative and the perforated appendicitis group. There was an increase in the hospital stay in the perforated appendicitis group. The postoperative complication rate was 4%, and the median operation time was 58.55 +/- 31.79 minutes. CONCLUSION: The single-incision laparoscopic appendectomy was easy and safe procedure for treating acute appendicitis. There were no differences in degree of inflammation and body mass index.
Appendectomy ; Appendicitis ; Body Mass Index ; Humans ; Inflammation ; Korea ; Laparoscopy ; Length of Stay ; Postoperative Complications ; Retrospective Studies

PURPOSE: Despite the reported advantages of laparoscopic appendectomy (LA), there is debate about the postoperative complication rates. Our study attempts to determine if laparoscopic appendectomy is safe and feasible compared with open appendectomy (OA). METHODS: A retrospective review was conducted of all patients who underwent open appendectomy (OA, 2,109 cases) and laparoscopic appendectomy (LA, 500 cases) at our hospital between 1997 and 2007. Incidental and interval appendectomies were excluded from this study. Demographic data, pathology, operation time, length of hospital stay, days to regular diet, and in hospital complication rate were identified. RESULTS: The peak age was 27 years. Seven of the 500 were converted to OA, yielding a conversion rate of 1.2%. The presence of non-visualized appendix, adhesion and technical failures were reasons for conversion. The distribution of histological stages of inflammation was comparable in both groups. The mean operating time was longer for the laparoscopic (64 min) than for the open procedure (58 min) (P<0.001). The complication rate after OA (7%) was significantly higher than that following LA (2.8%) (P=0.001). Hospital stay and frequency of analgesic administration were significantly lower in LA group than in OA group. CONCLUSION: Laparoscopic appendectomy is a safe and clinically beneficial operating procedure even in patients with appendicitis with peritonitis, perforation and abscess, resulting in shorter hospital stays and lower complication rates.
Abscess ; Appendectomy ; Appendicitis ; Appendix ; Diet ; Humans ; Inflammation ; Length of Stay ; Peritonitis ; Postoperative Complications ; Retrospective Studies