Israr Shumaila, Akhtar Jamshed, Taqvi Syed Muhammad Raees Hussain, Zamir Naima
Department of Paediatric Surgery, National Institute of Child Health, Jinnah Sindh Medical University, Karachi, Pakistan.
J Coll Physicians Surg Pak. 2021 Mar;31(3):302-306. doi: 10.29271/jcpsp.2021.03.302.
To find out the feasibility and safety of early surgery in pediatric patients who presented with appendicular mass.
Analytical observational study. Place and Duration of Study: Department of Paediatric Surgery, National Institute of Child Health, Jinnah Sindh Medical University, Karachi, from September 2019 to April 2020.
This study was conducted on 60 children, who were diagnosed with appendicular mass. Patients were operated after initial stabilisation and investigations. Variables analysed included demographic characteristics, clinical presentation, intraoperative surgical difficulties and postoperative complications. Data were entered into SPSS version 22. Chi-square test and Fisher Exact test were used for finding statistical significance among variables. A p-value of <0.05 was considered as significant. Results: There were 41 (68.4%) male and 19 (31.6%) female patients with the mean age of 8.3 + 2.9 year. Mean duration of pain was 3.8 + 1.8 days. In 41 (68.4%) patients, mass was composed of appendix with adherent ileal loops and omentum, while in 19 (31.6%) patients frank pus was also found within the mass. Thirty-four (56.6%) patients had suppurative appendix without gross perforation, while in 26 (43.4%) patients partially sloughed / gangrenous perforated appendix found. Intraoperative difficulties were more in patients with complex mass (p=0.004). Postoperative complications were observed in 14 (23.3%) patients. These were more frequent in female patients (p=0.001), with sloughed, gangrenous perforated appendix (p=0.034) and complex mass (p=0.008). Superficial wound infection was the most common complication noted in 9 (15%) patients. In 5 (8.3%) children, deep seated intra-abdominal collections were found. The mean hospital stay was 3.4 + 1.5 days. Conclusion: Early surgery in pediatric patients with appendicular mass was found feasible with minimal complications. This obviated the need of prolonged follow-up and interval appendectomy with its inherent risks. Key Words: Appendicular mass, Appendicular lump, Appendectomy, Child.
探讨对出现阑尾包块的儿科患者进行早期手术的可行性和安全性。
分析性观察研究。研究地点和时间：2019年9月至2020年4月，卡拉奇真纳信德医科大学国家儿童健康研究所小儿外科。
本研究对60例被诊断为阑尾包块的儿童进行。患者在初步稳定和检查后接受手术。分析的变量包括人口统计学特征、临床表现、术中手术难度和术后并发症。数据录入SPSS 22版。采用卡方检验和Fisher精确检验来确定变量之间的统计学显著性。p值<0.05被认为具有显著性。结果：有41例（68.4%）男性和19例（31.6%）女性患者，平均年龄为8.3±2.9岁。平均疼痛持续时间为3.8±1.8天。41例（68.4%）患者的包块由阑尾与粘连的回肠袢和大网膜组成，而19例（31.6%）患者的包块内还发现有明显脓液。34例（56.6%）患者为化脓性阑尾炎但无明显穿孔，而26例（43.4%）患者为部分脱落/坏疽穿孔性阑尾炎。复杂包块患者术中困难更多（p=0.004）。14例（23.3%）患者出现术后并发症。女性患者、有脱落/坏疽穿孔性阑尾炎的患者（p=0.034）和复杂包块患者（p=0.008）中并发症更常见。浅表伤口感染是9例（15%）患者中最常见的并发症。5例（8.3%）儿童发现有深部腹腔积液。平均住院时间为3.4±1.5天。结论：发现对有阑尾包块的儿科患者进行早期手术是可行的，并发症最少。这避免了长期随访以及间隔期阑尾切除术及其固有风险。关键词：阑尾包块、阑尾肿块、阑尾切除术、儿童
