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

PURPOSE: Acute gangrenous and perforated appendicitis are associated with an increased risk for intraoperative conversion, postoperative complications and have been considered a relative contraindication for laparoscopic appendectomy. The objective of this study was to analyze the feasibility of the laparoscopic approach in all forms of appendicitis. METHODS: A retrospective review of 101 patients who underwent laparoscopic appendectomy for uncomplicated and complicated appendicitis (perforated appendicitis and periappendiceal abscess) between June 2000 and May 2001 was performed. RESULTS: There were 84 patients with uncomplicated appendicitis (group A), 11 patients with perforated appendicitis (group B) and 16 patients with periappendiceal abscess (group C). The mean age of the patients was 42 (12~79) years and there were 47 men and 54 women. The mean operation time was 43, 67 and 105 minutes in groups A, B and C, respectively. Oral intake commenced at 1.4, 2.2 and 2.9 days and the hospital stay was 2.5, 2.9 and 5.2 days in groups A, B and C, respectively. There was no conversion to open surgery in groups A and B; however 4 patients in group C were converted. Complications were noted in 3 patients, one for each group. The overall complication rate was 2.9% and conversion rate, 0.9%. CONCLUSION: Although our experience is limited, the laparoscopic appendectomy seems to be a feasible and safe procedure for all forms of apppendicitis, including periappendiceal abscess.
Abscess ; Appendectomy* ; Appendicitis* ; Conversion to Open Surgery ; Female ; Humans ; Length of Stay ; Male ; Postoperative Complications ; Retrospective Studies

PURPOSE: We performed a study comparing the morbidity of laparoscopic and open appendectomy to assess whether laparoscopic appendectomy could be an initial procedure of choice for patients suffering with complicated appendicitis (gangrene, perforation and periappendiceal abscess). METHODS: We studied the patients who underwent appendectomy by either a laparoscopic or an open technique at Chungnam National University Hospital between January 2003 and July 2006. There were 118 patients in the laparoscopic appendectomy (LA) group and 232 patients in the open appendectomy (OA) group. RESULTS: The operating times and length of hospital stay were significantly shorter for the LA group than for the OA group (P < 0.05). Five patients (4.2 %) underwent conversion from LA to OA, but none of these patients showed more of a propensity for complications compared with the OA group. 51 of the 350 patients (14.6 %) had 67 postoperative complications, including wound infection, intraabdominal abscess, ileus ( > 72 hours) and small bowel obstruction. Complications were less frequent after LA compared with OA (10.2 % vs 23.7 %, respectively)(P = 0.01). There were less wound infections in the LA group than in the OA group (8.5% vs 14.2%, respectively)(P=0.02), and all the complications were minor compared with that for the OA group. A postoperative intraabdominal abscess developed in one patient in the OA group, but this didn't occur in the LA group. There were no serious complications requiring readmission or reoperation in the LA group. CONCLUSION: LA showed a significant benefit over OA in this study. The findings suggest that LA could be a safe primary choice for treating complicated appendicitis. To reach a final consensus on the scope of this study, a prospective randomized controlled study is needed in the near future.
Abscess ; Appendectomy* ; Appendicitis* ; Chungcheongnam-do ; Consensus ; Humans ; Ileus ; Length of Stay ; Postoperative Complications ; Reoperation ; Wound Infection

The presence of a malrotation of the midgut in adults is identified in asymptomatic patients most commonly as an incidental finding during a workup for an unrelated disease. We report here a rare case of acute perforated appendicitis in a patient with nonrotation of the midgut. A 28-year-old man was referred to our hospital with lower abdominal pain. The radiological examination, including abdominal computed tomography, ultrasonography, an upper gastrointestinal series, and a barium enema, revealed acute perforated appendicitis accompanied by nonrotation of the midgut. Emergency surgery revealed a complicated appendix located in the middle area of the lower abdomen with a periappendiceal abscess and nonrotation of the midgut. An ileocecal resection was performed with no postoperative complication. In this case, the atypical position of the appendix led to confusion regarding the diagnosis and to a more invasive surgical intervention.
Abdomen ; Abdominal Pain ; Abscess ; Adult ; Appendicitis ; Appendix ; Barium ; Emergencies ; Enema ; Humans ; Incidental Findings ; Postoperative Complications

PURPOSE: The advantage of a laparoscopic appendectomy for acute appendicitis in children is controversial, with no consensus among most pediatric surgeons, particularly with regard to the operative time and hospital costs in complicated cases. The objective of this study was to examine the safety, efficacy and complications of a laparoscopic appendectomy in children compared with an open appendectomy. METHODS: Our clinical experiences of laparoscopic appendectomy (LA) and open appendectomy (OA) for simple appendicitis (SA), complicated appendicitis (CA) and no evidence of appendicitis (NA) in children, between November, 2003 and October, 2006, were reviewed. Ninety- three (93) patients underwent a LA (58 boys, 35 girls) and 194 patients an OA (128 boys, 66 girls). The mean ages of the patients having undergone LA and OA were 9.6 and 8.9 years, respectively. RESULTS: The mean operation times were similar between the LA and OA in the SA and NA groups, but was shorter for a LA than an OA in the CA group, which was also statistically significant (P=0.007). There were statistically significant differences in the postoperative duration of hospital stay between a LA and an OA in all groups (in SA, 2.8 versus 4.5 days, P<0.001 and in CA, 4.5 versus 8.4 days, P<0.001). The rates of postoperative complications were different between a LA and an OA were: for the SA group, 1.7 versus 1.0%, P=1.000; for the CA group, 0 versus 22.4%, P=0.006. CONCLUSION: Our experiences suggest that a laparoscopic appendectomy was a safe and effective procedure for any type of appendicitis in children, with a shorter hospital stay and lower rate of postoperative complications.
Appendectomy* ; Appendicitis* ; Child* ; Consensus ; Hospital Costs ; Humans ; Length of Stay ; Operative Time ; Postoperative Complications