D'Abbicco Dario, Amoruso Michele, Notarnicola Annarita, Casagranda Biagio, Epifania Barbara, Margari Antonio
DACTI - Dipartimento per le Applicazioni in Chirurgia delle Tecnologie Innovative Facoltà di Medicina e Chirurgia, Università degli Studi di Bari.
Chir Ital. 2007 Mar-Apr;59(2):155-70.
Despite the indisputable progress of technology (laboratory analyses, scintigraphy, ultrasonography, computed tomography), the diagnosis of acute appendicitis often remains uncertain, with a rate of useless appendectomies amounting to almost 20% of cases. The ideal diagnostic test has yet to be discovered and, in any case, clinical observation remains the cornerstone of any decision-making algorithm. Thus, acute appendicitis continues to offer food for thought in relation to the aetiology of the condition, which is still unknown, the primacy of the clinical diagnosis, and the learning of the surgical skills required. In the present study, the authors compare their personal experience with the relevant data in the international literature, emphasising a number of issues such as the problem of diagnosis, acute appendicitis in pregnancy, laparoscopic therapy, and the so-called "useless appendectomies" and presenting their own point of view.
尽管技术(实验室分析、闪烁扫描、超声检查、计算机断层扫描)取得了无可争议的进步,但急性阑尾炎的诊断往往仍不明确,无用阑尾切除术的比例几乎占病例的20%。理想的诊断测试尚未被发现,无论如何,临床观察仍然是任何决策算法的基石。因此,急性阑尾炎在病因(仍不清楚)、临床诊断的首要地位以及所需手术技能的学习方面,仍然值得深入思考。在本研究中,作者将他们的个人经验与国际文献中的相关数据进行了比较,强调了一些问题,如诊断问题、妊娠期急性阑尾炎、腹腔镜治疗以及所谓的“无用阑尾切除术”,并提出了他们自己的观点。