|
KMID : 0371420170930020088
|
|
Annals of Surgical Treatment and Research
2017 Volume.93 No. 2 p.88 ~ p.97
|
|
|
Meaningful standard of reference for appendiceal perforation: pathology, surgery, or both?
|
|
Kim Hyuk-Jung
Kim Mi-Sung
Park Ji-Hoon
Ahn So-Yeon
Ko You-Sun
Song Soon-Young
Woo Ji-Young
Lee Kyoung-Ho
|
|
|
Abstract
|
|
|
Purpose: This retrospective study was aimed to determine if appendiceal perforation identified pathologically but not surgically is clinically meaningful.
Methods: The study consists of 2 parts. First, we reviewed 74 studies addressing appendiceal perforation published in 2012 and 2013. Second, in a cross-sectional study, we classified 1,438 adolescents and adults (mean age, 29.3 ± 8.4 years; 785 men) with confirmed appendicitis as “nonperforation” (n = 1,083, group 1), “pathologically-identified perforation” (n = 55, group 2), “surgically-identified perforation” (n = 202, group 3), or “pathologically- and surgically-identified perforation” (n = 98, group 4). The 4 groups were compared for the frequency of laparoscopic appendectomy and the length of hospital stay using multivariable logistic regression analyses.
Results: The reference standard for appendiceal perforation was frequently missing or inconsistent in the previous studies. Laparoscopic appendectomies were less frequent in groups 3 (52.5%, P = 0.001) and 4 (65%, P = 0.040) than in group 1 (70.7%), while group 2 (73%, P = 0.125) did not significantly differ from group 1. Median hospital stays were 2.9, 3.0, 5.1, and 6.0 days for groups 1?4, respectively. Prolonged hospital stay (≥3.7 days) was more frequent in groups 3 (77.7%, P < 0.001) and 4 (89%, P < 0.001) than in group 1 (23.4%), while group 2 (35%, P = 0.070) did not significantly differ from group 1.
Conclusion: We recommend using surgical rather than pathologic findings as the reference standard for the presence of appendiceal perforation in future investigations.
|
|
|
KEYWORD
|
|
|
Appendicitis, Perforation
|
|
|
FullTexts / Linksout information
|
|
|
|
|
Listed journal information
|
|
   
|
|