Department of General Surgery, University of Health Sciences, Istanbul Training and Research Hospital, İstanbul-Turkey.
Ulus Travma Acil Cerrahi Derg. 2022 May;28(5):703-710. doi: 10.14744/tjtes.2022.16287.
The aim of this study is to examine the cases underwent appendectomy during the COVID-19 pandemic and to discuss the pathology reports of patients.
During the COVID-19 pandemic, the pathological reports of the appendectomy materials of 588 patients over the age of 15 who applied to the emergency department between January 1, 2020, and June 1, 2021, were examined. A total of 565 patients with a diagnosis of acute (AA), subacute (SA), or perforated appendicitis (PA) were included and divided into three groups according to diagnosis. Twenty-three patients were excluded from the study due to other pathologies. The age, gender, duration of pain, ASA score, operational technique, operation time, Clavien-Dindo score, hospitalization time, post-operative complications, pre- and post-operative PCR and thoracic tomography findings in suspected cases of COVID-19, and laboratory and radiological findings of patients were retrospectively analyzed.
Of 565 patients diagnosed with appendicitis, 464 (82.1%) had AA, 35 (6.2%) SA, and 66 (11.7%) PA. The median age of the PA group was higher than in the AA group (p=0.0139). The incidence of diabetes mellitus in the PA group and of asthma in the SA group were highest among other groups (p=0.004 and 0.0037, respectively). The duration of pain was longer in the SA and PA groups than the AA group (p<0.0001), therefore, the patients applied to hospital later than the acute group. The rate of thorax CT-positive scans was 1.6% in patients suspected for COVID-19 (p=0.066). While laparoscopic surgery was preferred over 70% in all groups, the rate of conventional surgery (21.1%) in the AA group was highest and of transition from laparoscopic to open surgery was highest in the PA group (10.6%) (p<0.0001). Hospitalization duration was longest in the PA group (p<0.0001).
COVID-19 pandemic not only changes all routines of social life but also complicates the treatment and manage-ment of cases with AA symptoms applied to hospital under emergency conditions. Follow-up of the appendectomy specimen is crucial in terms of excluding other pathologies.
本研究旨在分析 COVID-19 大流行期间行阑尾切除术的病例，并讨论患者的病理报告。
在 COVID-19 大流行期间，对 2020 年 1 月 1 日至 2021 年 6 月 1 日期间因急症就诊的 588 例年龄大于 15 岁的阑尾切除术标本的病理报告进行了检查。共纳入 565 例急性（AA）、亚急性（SA）或穿孔性阑尾炎（PA）患者，根据诊断分为三组。由于其他病理原因，有 23 例患者被排除在研究之外。回顾性分析了疑似 COVID-19 患者的年龄、性别、疼痛持续时间、ASA 评分、手术技术、手术时间、Clavien-Dindo 评分、住院时间、术后并发症、术前和术后 PCR 及胸部 CT 检查结果，以及患者的实验室和影像学检查结果。
在 565 例诊断为阑尾炎的患者中，464 例（82.1%）为 AA，35 例（6.2%）为 SA，66 例（11.7%）为 PA。PA 组的中位年龄高于 AA 组（p=0.0139）。PA 组糖尿病发生率和 SA 组哮喘发生率最高（p=0.004 和 0.0037）。SA 和 PA 组的疼痛持续时间长于 AA 组（p<0.0001），因此这些患者比急性组更晚到医院就诊。疑似 COVID-19 患者胸部 CT 阳性扫描率为 1.6%（p=0.066）。虽然所有组均首选腹腔镜手术，但 AA 组的传统手术率（21.1%）最高，PA 组的从腹腔镜手术转为开放手术率（10.6%）最高（p<0.0001）。PA 组的住院时间最长（p<0.0001）。
COVID-19 大流行不仅改变了社会生活的所有常规，还使因 AA 症状就诊的急症患者的治疗和管理变得复杂。对阑尾切除标本的随访对于排除其他病理非常重要。
