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KMID : 0371320090760060360
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Journal of the Korean Surgical Society
2009 Volume.76 No. 6 p.360 ~ p.363
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The Effect of Delayed Surgery in Adult Patients with Acute Appendicitis
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Lee Min-A
Park Seung-Yeon
Lee Woon-Ki
Lee Young-Don
Park Yeon-Ho
Kim Hyun-Young
Kim Keon-Kuk
Chung Min
Choi Sang-Tae
Kang Jin-Mo
Park Heung-Kyu
Lee Jung-Nam
Yu Byung-Chul
Lee Won-Suk
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Abstract
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Purpose: There are many reports that delayed operation of appendicitis in children is safe, but it is controversial whether the same principle can be applicable in adult patients. The aim of this study was to evaluate the relationship between the interval from onset of symptoms to operation and the pathologic degree of appendicitis.
Methods: In this retrospective study, 783 adult patients (16 years old or more) diagnosed with appendicitis pathologically between 2004 and 2007 were included. The time from onset of symptoms to hospital arrival (patient interval) and time from hospital arrival to operation (hospital interval) were investigated. Pathologic and gross state of the appendicitis was graded as G1 (suppurative), G2 (gangrenous), G3 (ruptured), G4 (periappendiceal abscess).
Results: The median time from symptom onset to operation (total interval) was 35 hours. The percentage of G1, G2, G3, and G4 was 86.3%, 11.4%, 2.4%, and 0% when total interval was ＜24 hours, 61.3%, 21.3%, 15.8%, and 1.6% when between 24 and 72 hours, and 23.8%, 13.9%, 36.9%, and 25.4% when the interval was over 72 hours. The advanced grade of appendicitis correlated with increased hospital stay (P＜0.0001).
Conclusion: This study suggests that delayed appendectomy in acute appendicitis in adults is a risk factor for advanced grades, and that the sooner the operation is undertaken, the better the outcome is.
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KEYWORD
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Acute appendicitis, Appendectomy, Time, Delay
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