Department of Trauma and Emergency Surgery, Saiseikai Yokohamashi Tobu Hospital, Japan.
Am J Surg. 2018 Apr;215(4):599-602. doi: 10.1016/j.amjsurg.2017.06.033. Epub 2017 Jul 1.
Appendectomy has been the preferred treatment of acute appendicitis. However, extensive resection (ER) such as an ileocecal resection is sometimes needed. We analyzed the predictive factors of ER.
This was a retrospective study of 927 patients with acute appendicitis in 7 years. The data collected, including demographic characteristics, laboratory tests, computed tomography (CT) findings and days from onset.
ER was performed in 40 patients (4.3%). Age, days from onset, C-reactive protein (CRP), and the presence of several CT findings were significantly higher in the ER group than others (p < 0.01). In a multivariate analysis, four variables (appendiceal mass, non-visualization of appendix, delayed admission, and CRP) retained statistical significance as predictors of ER (p < 0.01).
We demonstrated that the four factors are clinically useful for predicting preoperatively whether or not ER is required. These may help in management decisions, including surgical procedure and anesthesia.
阑尾切除术一直是急性阑尾炎的首选治疗方法。然而，有时需要广泛切除（ER），如回盲部切除术。我们分析了 ER 的预测因素。
这是一项回顾性研究，纳入了 7 年内 927 例急性阑尾炎患者。收集的数据包括人口统计学特征、实验室检查、计算机断层扫描（CT）结果和发病天数。
在 40 例患者（4.3%）中进行了 ER。ER 组的年龄、发病天数、C 反应蛋白（CRP）和几种 CT 表现明显高于其他组（p<0.01）。多变量分析显示，阑尾肿块、阑尾不显影、延迟入院和 CRP 是 ER 的预测因素（p<0.01）。
我们证明了这四个因素在术前预测是否需要 ER 方面具有临床意义。这些因素可能有助于管理决策，包括手术程序和麻醉。
