Parreira José Gustavo, DE-Godoy Louisie Galantini Lana, DE-Campos Tercio, Lucarelli-Antunes Pedro DE Souza, DE-Oliveira-E-Silva Luiz Gustavo, Santos Heitor Gavião, Luna Renato Abrantes, Portari Filho Pedro Eder, Assef Jose Cesar
- Faculdade de Ciências Médicas da Santa Casa de São Paulo, Departamento de Cirurgia - São Paulo - SP - Brasil.
- Irmandade da Santa Casa de Misericórdia de São Paulo, Serviço de Emergência - São Paulo - SP - Brasil.
Rev Col Bras Cir. 2021 Oct 11;48:e20202717. doi: 10.1590/0100-6991e-20202717. eCollection 2021.
Acute appendicitis (AA) is a frequent cause of abdominal pain requiring surgical treatment. During the COVID-19 pandemic, surgical societies considered other therapeutic options due to uncertainties in the evolution of the disease. The purpose of this study is to assess the treatment of AA by members of two Brazilian surgical societies in this period. A common questionnaire was sent in 2020. There were 382 responses. Most surgeons had more than 15 years of profession (68.3%) and treated more than five cases per month (44.8%). About 72.5% would indicate chest CT to investigate COVID-19 in patients with AA. For those patients sustaining uncomplicated AA, without COVID-19, 60.2% would indicate laparoscopic appendectomy (VLA), followed by open appendectomy (OA) (31.7%) and non-operative management (NOM) (1.3%). For those with mild COVID-19, OA was suggested by 51.0%, followed by VLA (29.6%) and NOM (6.0%). For those with severe COVID-19, OA was proposed by 35.3%, followed by NOM (19.9%) and VLA (18.6%). For patients with periappendiceal abscesses, without COVID-19, VLA was suggested by 54.2%, followed by OA (33.2%) and NOM (4.4%). For those with mild COVID-19, OA was proposed in 49.5%, followed by VLA (29.3%) and NOM (8.9%). In those with severe COVID-19, OA was proposed in 36.6%, followed by NOM (25.1%) and VLA (17.3%). This information, based on two recognized Brazilian surgical societies, can help the surgeon to select the best approach individually.
急性阑尾炎（AA）是需要手术治疗的腹痛的常见原因。在新冠疫情期间，由于疾病发展的不确定性，外科学会考虑了其他治疗选择。本研究的目的是评估在此期间两个巴西外科学会成员对AA的治疗情况。2020年发放了一份通用问卷。共收到382份回复。大多数外科医生有超过15年的从业经验（68.3%），每月治疗超过5例病例（44.8%）。约72.5%的医生会建议对AA患者进行胸部CT检查以排查新冠。对于那些无新冠的单纯性AA患者，60.2%的医生会建议行腹腔镜阑尾切除术（VLA），其次是开腹阑尾切除术（OA）（31.7%）和非手术治疗（NOM）（1.3%）。对于轻度新冠患者，51.0%的医生建议行OA，其次是VLA（29.6%）和NOM（6.0%）。对于重度新冠患者，35.3%的医生建议行OA，其次是NOM（19.9%）和VLA（18.6%）。对于阑尾周围脓肿患者，无新冠时，5
