Current surgical practice in U.S. adults involves presurgery imaging, laparoscopic approach
FRIDAY, March 8, 2019 (HealthDay News) — Preoperative imaging, a laparoscopic approach, and excellent clinical outcomes are the norm for the surgical management of uncomplicated appendicitis in U.S. adults, according to research published in the March issue of Surgery.
Christopher P. Childers, M.D., from the University of California in Los Angeles, and colleagues developed an epidemiologic profile of adults with uncomplicated appendicitis using data merged from the 2016 National Surgical Quality Improvement Program essential and appendectomy-targeted participant use files (12,376 adult appendectomies from 115 National Surgical Quality Improvement Program sites).
Based on an analysis of 7,778 cases, the researchers found that almost all patients (96.1 percent) received preoperative imaging, with most (79.2 percent) receiving a computed tomography scan only. Few appendectomies were performed open (2.6 percent), with a laparoscopic to open conversion rate of 0.5 percent. The majority of patients (87.3 percent) were discharged the day of or the day after their operation. Incidental tumors were identified in 1.1 percent of cases, with higher rates among older patients (2.7 percent among patients aged ≥65 years). The overall rate of a negative appendectomy was 3.8 percent, but it was higher (19.4 percent) for patients with no preoperative imaging. The 30-day mortality rate was 0.04 percent; for any complication and serious complications, the 30-day mortality rates were 3.0 and 2.2 percent, respectively.
“As surgeons contemplate the role of nonoperative therapy for uncomplicated appendicitis, the data presented here should be used to inform the ongoing debate,” the authors write.
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