Ceresoli Marco, Zucchi Alberto, Allievi Niccolò, Harbi Asaf, Pisano Michele, Montori Giulia, Heyer Arianna, Nita Gabriela E, Ansaloni Luca, Coccolini Federico
Marco Ceresoli, Niccolò Allievi, Asaf Harbi, Michele Pisano, Giulia Montori, Gabriela E Nita, Luca Ansaloni, Federico Coccolini, General Surgery Unit, Papa Giovanni XXIII Hospital, 24127 Bergamo, Italy.
World J Gastrointest Surg. 2016 Oct 27;8(10):693-699. doi: 10.4240/wjgs.v8.i10.693.
To investigate the epidemiology, treatment and outcomes of acute appendicitis (AA) in a large population study.
This is a retrospective cohort study derived from the administrative dataset of the Bergamo district healthcare system (more than 1 million inhabitants) from 1997 to 2013. Data about treatment, surgery, length of stay were collected. Moreover for each patients were registered data about relapse of appendicitis and hospital admission due to intestinal obstruction.
From 1997 to 2013 in the Bergamo district we collected 16544 cases of AA, with a crude incidence rate of 89/100000 inhabitants per year; mean age was 24.51 ± 16.17, 54.7% were male and the mean Charlson's comorbidity index was 0.32 ± 0.92. Mortality was < 0.0001%. Appendectomy was performed in 94.7% of the patients and the mean length of stay was 5.08 ± 2.88 d; the cumulative hospital stay was 5.19 ± 3.36 d and 1.2% of patients had at least one further hospitalization due intestinal occlusion. Laparoscopic appendectomy was performed in 48% of cases. Percent of 5.34 the patients were treated conservatively with a mean length of stay of 3.98 ± 3.96 d; the relapse rate was 23.1% and the cumulative hospital stay during the study period was 5.46 ± 6.05 d.
The treatment of acute appendicitis in Northern Italy is slowly changing, with the large diffusion of laparoscopic approach; conservative treatment of non-complicated appendicitis is still a neglected option, but rich of promising results.
在一项大规模人群研究中调查急性阑尾炎（AA）的流行病学、治疗方法及治疗结果。
这是一项回顾性队列研究，数据来源于1997年至2013年贝加莫地区医疗系统的管理数据集（居民超过100万）。收集了有关治疗、手术、住院时间的数据。此外，还记录了每位患者阑尾炎复发和肠梗阻住院的数据。
1997年至2013年期间，在贝加莫地区我们共收集到16544例急性阑尾炎病例，粗发病率为每年89/10万居民；平均年龄为24.51±16.17岁，男性占54.7%，平均查尔森合并症指数为0.32±0.92。死亡率<0.0001%。94.7%的患者接受了阑尾切除术，平均住院时间为5.08±2.88天；累计住院时间为5.19±3.36天，1.2%的患者因肠梗阻至少再次住院一次。48%的病例实施了腹腔镜阑尾切除术。5.34%的患者接受了保守治疗，平均住院时间为3.98±3.96天；复发率为23.1%，研究期间的累计住院时间为5.46±6.05天。
意大利北部急性阑尾炎的治疗方式正在缓慢改变，腹腔镜手术方法得到广泛应用；非复杂性阑尾炎的保守治疗仍是一个被忽视的选择，但有着可观的前景。
