Department of General Surgery, Ankara University Faculty of Medicine, Ankara-Türkiye.
Department of General Surgery, University of Health Science Kanuni Sultan Süleyman Training and Research Hospital, İstanbul-Türkiye.
Ulus Travma Acil Cerrahi Derg. 2022 Dec;28(12):1682-1689. doi: 10.14744/tjtes.2022.97892.
The novel coronavirus disease 2019 (COVID-19) has resulted in major changes in health-care systems and emer-gency surgical interventions. Here, we examined patients with acute appendicitis who presented to emergency departments and com-pared diagnosis, treatment, and post-treatment processes before and during the pandemic period and investigated how the pandemic affected management of acute appendicitis.
A national, multicenter, and cohort study model was designed that included patients older than 18 years of age diag-nosed with acute appendicitis clinically and/or radiologically, with patients compared before (pre-pandemic period: January 1-April 30, 2019) and after (pandemic period: January 1-April 30, 2020) the pandemic. Our investigation included comparisons of pre-operative imaging methods, presence of plastron appendicitis/abscess, conservative/surgical approach, type of anesthesia given, laparoscopic/open surgical approach, bowel resection rates, drain insertion rates, and presence of post-operative complications RESULTS: For the two study groups, 8972 patients from 69 centers were examined, with 4582 patients operated in the pre-pan-demic period and 4234 patients operated in the pandemic period. During the pandemic period, 63.6% of patients underwent open surgery, whereas 34.4% had laparoscopic surgery. Although 60 patients (1.3%) requested non-operative follow-up in the pre-pandemic period, 94 patients (2.2%) requested this in the pandemic period. When conditions of patients were evaluated regardless of their own wishes, 114 patients (2.4%) before and 163 patients (3.8%) during the pandemic received non-operative follow-up.
Our study did not show the direct correlation between the application of COVID-19-related restrictions and the severity of acute appendicitis. Although non-operative management rates have been increased during the COVID-19 period, the incidences of both complicated and the uncomplicated appendicitis were similar during the COVID-19 crisis period. Given this infor-mation non-operative management can be employed for patients diagnosed with appendicitis.
新型冠状病毒病 2019（COVID-19）导致医疗系统和紧急外科干预发生重大变化。在这里，我们检查了因急性阑尾炎就诊于急诊的患者，并比较了大流行前和大流行期间的诊断、治疗和治疗后过程，并研究了大流行如何影响急性阑尾炎的管理。
设计了一项全国性、多中心、队列研究模型，纳入了年龄大于 18 岁的经临床和/或放射学诊断为急性阑尾炎的患者，将患者分为大流行前（2019 年 1 月 1 日至 4 月 30 日）和大流行后（2020 年 1 月 1 日至 4 月 30 日）两个时期进行比较。我们的调查包括比较术前影像学方法、有无 Plastron 阑尾炎/脓肿、保守/手术治疗方法、给予的麻醉类型、腹腔镜/开放性手术方法、肠切除率、引流管插入率以及术后并发症的存在。
在这两个研究组中，检查了来自 69 个中心的 8972 名患者，其中 4582 名患者在大流行前进行了手术，4234 名患者在大流行期间进行了手术。在大流行期间，63.6%的患者接受了开放性手术，而 34.4%的患者接受了腹腔镜手术。虽然在大流行前有 60 名患者（1.3%）要求非手术随访，但在大流行期间有 94 名患者（2.2%）要求非手术随访。在不考虑患者自身意愿的情况下评估患者病情时，有 114 名患者（2.4%）在大流行前和 163 名患者（3.8%）在大流行期间接受了非手术随访。
我们的研究并未显示 COVID-19 相关限制的实施与急性阑尾炎严重程度之间存在直接相关性。尽管在 COVID-19 期间非手术治疗率有所增加，但 COVID-19 危机期间复杂和不复杂阑尾炎的发生率相似。根据这些信息，可以对诊断为阑尾炎的患者进行非手术治疗。
