Department of General Surgery, Faculty of Medicine, Zagazig University, Egypt Doncaster and Bassetlaw Teaching Hospitals, NHS Foundation Trust, Sheffield University, UK Department of Surgery, Hospital Alemán of Buenos Aires, Argentina Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, Rasool-e Akram Hospital, Iran University of Medical Sciences, Tehran, Iran Department of Biomedical Sciences for Health Milan, Italy Surgery Department General Hospital Aleksinac, Serbia.
Int J Surg. 2022 Jan;97:106200. doi: 10.1016/j.ijsu.2021.106200. Epub 2021 Dec 29.
COVID-19 infection is a global pandemic that affected routine health services and made patients fear to consult for medical health problems, even acute abdominal pain. Subsequently, the incidence of complicated appendicitis increased during the Covid-19 pandemic. This study aimed to evaluate recurrent appendicitis after successful drainage of appendicular abscess during COVID-19.
A prospective cohort study conducted in the surgical emergency units of our Universities' Hospitals between March 15, 2020 to August 15, 2020 including patients who were admitted with the diagnosis of an appendicular abscess and who underwent open or radiological drainage. Main outcomes included incidence, severity, and risk factors of recurrent appendicitis in patients without interval appendectomy.
A total of 316 patients were included for analysis. The mean age of the patients was 37 years (SD ± 13). About two-thirds of patients were males (60.1%). More than one-third (39.6%) had co-morbidities; type 2 diabetes mellitus (T2DM) (22.5%) and hypertension (17.1%) were the most frequent. Approximately one quarter (25.6%) had confirmed COVID 19 infection. About one-third of the patients (30.4%) had recurrent appendicitis. More than half of them (56.3%) showed recurrence after three months, and 43.8% of patients showed recurrence in the first three months. The most frequent grade was grade I (63.5%). Most patients (77.1%) underwent open surgery. Age, T2DM, hypertension, COVID-19 infection and abscess size >3 cm were significantly risking predictors for recurrent appendicitis.
Interval appendectomy is suggested to prevent 56.3% of recurrent appendicitis that occurs after 3 months. We recommend performing interval appendectomy in older age, people with diabetes, COVID-19 infected, and abscesses more than 3 cm in diameter.
Is interval appendectomy preventing a high incidence of recurrent appendicitis after successful drainage of appendicular abscess during COVID-19 pandemic?
COVID-19 感染是一种全球大流行疾病，它影响了常规的卫生服务，使患者害怕因医疗健康问题就诊，即使是急性腹痛。随后，COVID-19 大流行期间复杂阑尾炎的发病率增加。本研究旨在评估 COVID-19 期间阑尾脓肿成功引流后复发性阑尾炎的发生情况。
这是一项在我们大学医院的外科急诊病房进行的前瞻性队列研究，研究对象为诊断为阑尾脓肿并接受开放或放射学引流的患者。主要结局包括无间隔阑尾切除术患者复发性阑尾炎的发生率、严重程度和危险因素。
共纳入 316 例患者进行分析。患者的平均年龄为 37 岁（标准差 ± 13 岁）。约三分之二的患者为男性（60.1%）。超过三分之一（39.6%）的患者合并有合并症；2 型糖尿病（T2DM）（22.5%）和高血压（17.1%）最为常见。约四分之一（25.6%）的患者确诊 COVID-19 感染。约三分之一的患者（30.4%）出现复发性阑尾炎。其中超过一半（56.3%）在 3 个月后出现复发，43.8%的患者在头 3 个月内复发。最常见的等级为 I 级（63.5%）。大多数患者（77.1%）接受了开放手术。年龄、T2DM、高血压、COVID-19 感染和脓肿直径>3cm 是复发性阑尾炎的显著危险因素。
间隔阑尾切除术可预防 56.3%的复发性阑尾炎，这些阑尾炎发生在 3 个月后。我们建议对年龄较大、患有糖尿病、COVID-19 感染和脓肿直径大于 3cm 的患者行间隔阑尾切除术。
在 COVID-19 大流行期间成功引流阑尾脓肿后，间隔阑尾切除术是否能预防复发性阑尾炎的高发？
