Department of Surgery, Sant'Eugenio Hospital, Piazzale dell'Umanesimo 10, 00144, Rome, Italy.
Emergency Surgery Unit, University Hospital of Tor Vergata, viale Oxford 81, 00133, Rome, Italy.
Int J Colorectal Dis. 2021 Oct;36(10):2287-2290. doi: 10.1007/s00384-021-03959-x. Epub 2021 May 27.
During the past months, the Italian Government has reduced the restrictions and access to hospitals. Since then, up to 40% of non-traumatic abdominal emergencies have had unusual delayed treatment. Given the rapidly evolving situation and the absence of evidence to support recommendations during the pandemic, it is useful to assess how the current situation is influencing the management of elderly with acute appendicitis.
Between February 2020 and December 2020, all patients older than 68 years old undergone appendectomy were included. Surgical approach, hospital stay, post-operative complications, radiology reports, and histologic examination were included in the retrospective analysis and compared with a same sample of the same period before the pandemic.
Twenty-seven patients underwent appendectomy for acute appendicitis during the pandemic and 34 patients in the pre-outbreak period. Laparoscopic approach was completed in 51.8% of the cases, while conversion to laparotomy in 22.3% of patients and open procedure in the 25.9%, before the pandemic 73.6%, 14.7%, and 11.7%, respectively. During the pandemic, complicated appendicitis occurred in 59.3% of the cases (26.5% before the outbreak). One patient was treated for a pelvic abscess, while no minor complications were detected. No mortality rate was reported, with a mean hospital stay of 5.64 days during the outbreak and 4.21 days before the pandemic.
Our data highlighted a partial delay in diagnosis in the elderly group, and an increase in complicated appendicitis also demonstrated by the need for conversion to laparotomy.
在过去的几个月里，意大利政府已经放宽了对医院的限制并允许更多人进入。自那时以来，多达 40%的非创伤性腹部急症患者的治疗被延迟。鉴于疫情形势迅速发展，且缺乏大流行期间支持推荐意见的证据，评估当前形势如何影响老年急性阑尾炎的治疗具有重要意义。
在 2020 年 2 月至 2020 年 12 月期间，纳入所有年龄大于 68 岁的接受阑尾切除术的患者。回顾性分析手术方式、住院时间、术后并发症、影像学报告和组织学检查，并与疫情前同期的相同样本进行比较。
在疫情期间有 27 例老年急性阑尾炎患者接受阑尾切除术，而在疫情前有 34 例。腹腔镜手术完成 51.8%，而转为开腹手术的占 22.3%，开放手术占 25.9%，疫情前分别为 73.6%、14.7%和 11.7%。在疫情期间，复杂阑尾炎的发生率为 59.3%（疫情前为 26.5%）。1 例患者接受了盆腔脓肿治疗，无轻微并发症。无死亡率，疫情期间的平均住院时间为 5.64 天，疫情前为 4.21 天。
我们的数据表明，老年组的诊断存在部分延迟，且复杂阑尾炎的发生率增加，需要转为开腹手术。
