Department of General Surgery.
Colorectal Unit, Rambam Health Care Campus, Haifa, Israel.
Surg Laparosc Endosc Percutan Tech. 2021 May 27;31(5):599-602. doi: 10.1097/SLE.0000000000000952.
Acute appendicitis is one of the most common emergencies treated by general surgeons. The treatment of choice in the majority of cases is laparoscopic appendectomy. In the era of the COVID-19 pandemic, there is a concern for a delayed referral of patients and thus a more advanced presentation of the disease leading to a prolonged and complicated course.
Retrospective review of a computerized database of patients who were admitted with acute appendicitis and underwent laparoscopic appendectomy during the COVID pandemic in a single tertiary center in Israel. Patients were compared with those who were admitted and operated for appendicitis in the same period in the previous year.
One hundred twenty-three patients underwent laparoscopic appendectomy in the study period in 2020, compared with 109 who had surgery in 2019. During the COVID pandemic 41 patients presented with complicated appendicitis versus 22 patients in 2019 (P=0.0174). The placement of peritoneal drains was more prevalent during the pandemic, 5.5% versus 11.4%, and the use of stapler device for appendicular stump closure (P=0.0105).
During the first stage of the COVID-19 pandemic, there was a significant increase in the rate of complicated appendicitis. Patients should be strongly encouraged not to refrain from medical treatment and go to the emergency room with the persistence of symptoms.
急性阑尾炎是普通外科医生治疗的最常见急症之一。在大多数情况下，首选治疗方法是腹腔镜阑尾切除术。在 COVID-19 大流行期间，人们担心患者的转诊会延迟，从而导致疾病的表现更为严重，导致病程延长和复杂化。
回顾性分析了一家以色列三级中心在 COVID 大流行期间收治的 123 例急性阑尾炎并接受腹腔镜阑尾切除术的计算机数据库。将这些患者与同年同一时期因阑尾炎入院并接受手术的患者进行比较。
2020 年研究期间有 123 例患者接受腹腔镜阑尾切除术，而 2019 年有 109 例。在 COVID 大流行期间，有 41 例患者表现为复杂性阑尾炎，而 2019 年有 22 例（P=0.0174）。在大流行期间，腹腔引流管的放置更为普遍，为 5.5%，而使用吻合器装置闭合阑尾残端（P=0.0105）。
在 COVID-19 大流行的第一阶段，复杂性阑尾炎的发生率显著增加。应强烈鼓励患者不要因症状持续而避免就医并前往急诊室。
