Lee Seung Hyun, Park Sung-Soo, Seo Ho Seok
Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea.
Division of Hematology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea.
Cancers (Basel). 2023 Oct 19;15(20):5049. doi: 10.3390/cancers15205049.
Appendicitis is a prevalent surgical emergency. Although appendectomy has traditionally been the go-to treatment, recent studies suggest antibiotics can be equally effective for uncomplicated cases. However, evidence is scant regarding patients with hematologic disorders. This study delves into the surgical risks tied to appendicitis in patients with underlying hematologic conditions. A retrospective analysis was carried out on patients diagnosed with appendicitis and hematologic disorders from January 2000 to June 2021. Patients were pinpointed using ICD-10 diagnostic codes, and surgical procedures were identified based on the hospital's surgical fee codes. Hematologic conditions were sorted into risk levels, and patient treatments were scrutinized. Among the 131 initially identified patients, 89 were included in the study. Out of these, 75 underwent surgical procedures, while 14 received non-surgical treatments. The surgical group displayed better preoperative laboratory outcomes. Clinical characteristics, hematologic disease risk, and severity of appendicitis appeared not to be related to surgical complications. Patients without surgical complications showed improvement in preoperative absolute neutrophil count (ANC) and platelet counts. Lower preoperative ANCs and platelet counts were associated with extended hospital stays. For patients with hematologic disorders diagnosed with appendicitis, thorough preoperative laboratory evaluations followed by minimally invasive appendectomy appear to be a safe route without heightening the risk of severe complications compared to non-surgical management.
阑尾炎是一种常见的外科急症。虽然传统上阑尾切除术一直是首选治疗方法，但最近的研究表明，抗生素对于非复杂性病例同样有效。然而，关于血液系统疾病患者的证据却很少。本研究深入探讨了患有潜在血液系统疾病的阑尾炎患者的手术风险。对2000年1月至2021年6月期间被诊断为阑尾炎和血液系统疾病的患者进行了回顾性分析。使用国际疾病分类第十版（ICD-10）诊断代码确定患者，并根据医院的手术费用代码确定手术程序。将血液系统疾病分为风险等级，并对患者的治疗进行审查。在最初确定的131名患者中，89名被纳入研究。其中，75名接受了手术治疗，14名接受了非手术治疗。手术组术前实验室检查结果更好。临床特征、血液系统疾病风险和阑尾炎严重程度似乎与手术并发症无关。无手术并发症的患者术前绝对中性粒细胞计数（ANC）和血小板计数有所改善。术前ANC和血小板计数较低与住院时间延长有关。对于诊断为阑尾炎的血液系统疾病患者，与非手术治疗相比，术前进行全面的实验室评估后进行微创阑尾切除术似乎是一条安全的途径，不会增加严重并发症的风险。
