Panahi Pedram, Ibrahim Rashid, Veeralakshmanan Pushpa, Ackah James, Coleman Mark
Department of General Surgery, University Hospitals Plymouth NHS Trust, Derriford Road, Plymouth, PL6 8DH, United Kingdom.
Ann Med Surg (Lond). 2020 Aug 31;59:274-277. doi: 10.1016/j.amsu.2020.08.033. eCollection 2020 Nov.
A Best Evidence Topic in general surgery was written according to a structured protocol. The question addressed was 'Appendiceal phlegmon in adults: Do we know how to manage it yet?'. Altogether 217 papers were found on Ovid Embase and Medline, 334 on PubMed and 13 on the Cochrane database using the reported search. From the screened articles, 5 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. We conclude that the best management method is conservative only treatment without interval appendicectomy. These patients must be followed up, including colonoscopy and/or CT imaging as indicated, to investigate for conditions such as inflammatory bowel disease or malignancy masquerading as appendicitis.
一篇普通外科的最佳证据主题文章是按照结构化协议撰写的。所探讨的问题是“成人阑尾蜂窝织炎：我们现在知道如何处理它了吗？” 使用报告的检索方式，在Ovid Embase和Medline上共找到217篇论文，在PubMed上找到334篇，在Cochrane数据库上找到13篇。从筛选出的文章中，有5篇代表了回答该临床问题的最佳证据。这些论文的作者、期刊、出版日期和国家、研究的患者群体、研究类型、相关结局和结果都列成了表格。我们得出结论，最佳的处理方法是仅采用保守治疗而不进行间隔期阑尾切除术。必须对这些患者进行随访，包括根据需要进行结肠镜检查和/或CT成像，以调查是否存在诸如伪装成阑尾炎的炎症性肠病或恶性肿瘤等情况。
