Craner Domenic R, Wexler Justin I, Nalugo Margaret, Ponsky Todd A
1 Department of Pediatric Surgery, Akron Children's Hospital , Akron, Ohio.
J Laparoendosc Adv Surg Tech A. 2015 Mar;25(3):261-5. doi: 10.1089/lap.2014.0347. Epub 2014 Oct 7.
Despite appendicitis being one of the most common surgical emergencies in the pediatric population, there is still a great deal of debate among pediatric surgeons regarding the workup and treatment.
In an interactive Web symposium consisting of 130 pediatric surgeons from various regions of the world, questions about diagnosis and management of appendicitis were displayed on the screen. The audience was asked to respond to the poll questions. The questions asked to the participants pertained to an example case of a 12-year-old boy presenting to the emergency department with the classic history and exam for appendicitis.
The total number of respondents varied between 30 and 37, giving response rates of 23%-28%. Sixty-six percent of respondents would not order imaging. Thirty-one percent said that they would order ultrasound. No participant would order a computed tomography scan, whereas 5% would order some other form. Ninety-five percent of respondents said that they would treat the patient operatively. The majority (89%) of the participants felt comfortable waiting until morning to operate on the patient if the patient arrived at 11 p.m. Fifty-seven percent stated that they would use a three-port laparoscopic approach, and 38% would use a single port, whereas 5% would use an open surgical approach. The majority (34%) reported being able to visualize the appendix as the greatest benefit to using laparoscopy. Fifty-seven percent would give the patient one additional dose of antibiotics and then discharge him 24 hours later following treatment for acute, nonperforated appendicitis. Twenty percent of respondents would give no further antibiotics and would discharge the patient from the recovery room or soon after. Sixteen percent would not give any additional antibiotics and would discharge him 24 hours postoperatively, whereas 6% would give one additional dose of antibiotics and discharge him soon after.
The use of virtual broadcasts affords a unique opportunity to surgeons around the world to share and learn from each other.
尽管阑尾炎是儿科最常见的外科急症之一，但儿科外科医生在检查和治疗方面仍存在大量争议。
在一个由来自世界各地的130名儿科外科医生参加的互动网络研讨会上，关于阑尾炎诊断和管理的问题显示在屏幕上。要求与会者回答投票问题。向参与者提出的问题涉及一名12岁男孩因典型的阑尾炎病史和检查到急诊科就诊的示例病例。
受访者总数在30至37人之间，回复率为23% - 28%。66%的受访者不会安排影像学检查。31%的人表示会安排超声检查。没有参与者会安排计算机断层扫描，而5%的人会安排其他形式的检查。95%的受访者表示会对患者进行手术治疗。如果患者晚上11点到达，大多数（89%）参与者认为等到早上为患者进行手术没问题。57%的人表示会采用三孔腹腔镜手术方法，38%的人会采用单孔手术方法，而5%的人会采用开放手术方法。大多数（34%）报告称能够看到阑尾是使用腹腔镜手术的最大益处。对于急性非穿孔性阑尾炎患者，57%的人会再给患者一剂抗生素，然后在治疗24小时后让其出院。20%的受访者不会再给抗生素，会在患者从恢复室出来后或不久就让其出院。16%的人不会再给任何额外抗生素，会在术后24小时让其出院，而6%的人会再给一剂抗生素并很快让其出院。
虚拟广播的使用为世界各地的外科医生提供了一个独特的机会，使他们能够相互分享和学习。
