Department of General Surgery, Kahramanmaraş Elbistan State Hospital, Kahramanmaraş-Türkiye.
Ulus Travma Acil Cerrahi Derg. 2022 Jul;28(7):894-899. doi: 10.14744/tjtes.2021.45944.
This study aims to compare medical treatment and appendectomy in patients diagnosed with uncomplicated acute appendicitis during the COVID-19 pandemic.
Retrospectively analyzed were the data of 80 patients who received medical or surgical treatment for uncomplicated acute appendicitis between March 15, 2020, and August 31, 2020. The demographic characteristics of the patients, length of hospital stay, physical examination and radiology findings, laboratory results, and any complications were recorded. Patients were divided into two groups depending on the mode of treatment, as surgical and non-surgical.
Forty patients were given medical treatment and 40 patients were directly operated on for appendicitis. Of the 40 patients who received medical treatment, 8 (20%) ended up requiring an operation due to recurrence. The mean duration of hospitalization was 2 days (range: 1-3), and the mean follow-up duration was 285.35±65.66 days (range: 101-379). The white blood cell count was significantly higher in the surgical group (p=0.004), and the length of hospital stay was longer in the non-surgical group (p<0.001). The prevalence of post-operative complications was similar for patients who underwent appendectomy directly on admission or after recurrence (p=1.000). Among the patients who received medical treatment, the most important predictors of requiring surgery were the red cell distribution width and increased appendix diameter in computed tomography (p<0.05).
Medical treatment is an effective alternative in patients with uncomplicated appendicitis. Even in the case of a recurrence in follow-up, surgery due to a potential recurrence is not associated with an increased rate of complication compared to direct surgery.
本研究旨在比较 COVID-19 大流行期间诊断为单纯性急性阑尾炎患者的内科治疗和阑尾切除术。
回顾性分析了 2020 年 3 月 15 日至 2020 年 8 月 31 日期间接受单纯性急性阑尾炎内科或手术治疗的 80 例患者的数据。记录了患者的人口统计学特征、住院时间、体格检查和影像学发现、实验室结果以及任何并发症。根据治疗方式将患者分为手术组和非手术组。
40 例患者接受内科治疗，40 例患者直接手术治疗阑尾炎。在接受内科治疗的 40 例患者中，有 8 例（20%）因复发而最终需要手术。住院时间的平均值为 2 天（范围：1-3 天），平均随访时间为 285.35±65.66 天（范围：101-379 天）。手术组的白细胞计数明显较高（p=0.004），非手术组的住院时间较长（p<0.001）。直接入院或复发后行阑尾切除术的患者术后并发症发生率相似（p=1.000）。在内科治疗的患者中，需要手术的最重要预测因素是红细胞分布宽度和 CT 检查中阑尾直径增加（p<0.05）。
内科治疗是单纯性阑尾炎患者的有效替代方法。即使在随访中复发，与直接手术相比，因潜在复发而进行的手术也不会增加并发症的发生率。
