학술논문

Prospective Observational Study on acute Appendicitis Worldwide (POSAW)
Document Type
article
Author
Massimo SartelliGian L. BaiocchiSalomone Di SaverioFrancesco FerraraFrancesco M. LabricciosaLuca AnsaloniFederico CoccoliniDeepak VijayanAshraf AbbasHariscine K. AbongwaJohn AgboolaAdamu AhmedLali AkhmeteliNezih AkkapuluSeckin AkkucukFatih AltintoprakAurelia L. AndreievDimitrios AnyfantakisBoiko AtanasovMiklosh BalaDimitrios BalalisOussama BaraketGiovanni BellanovaMarcelo BeltranRenato Bessa MeloRoberto BiniKonstantinos BouliarisDaniele BrunelliAdrian CastilloMarco CataniAsri Che JusohAlain Chichom-MefireGianfranco CocorulloRaul CoimbraElif ColakSilvia CostaKoray DasSamir DelibegovicZaza DemetrashviliIsidoro Di CarloNadezda KiselevaTamer El ZalabanyMario FaroMargarida FerreiraGustavo P. FragaMahir GachabayovWagih M. GhnnamTeresa Giménez MaurelGeorgios GkiokasCarlos A. GomesEwen GriffithsAli GunerSanjay GuptaAndreas HeckerElcio S. HiranoAdrien HodonouMartin HutanOrestis IoannidisArda IsikGeorgy IvakhovSumita JainMantas JokubauskasAleksandar KaramarkovicSaila KauhanenRobin KaushikAlfie KavalakatJakub KenigVladimir KhokhaDesmond KhorDennis KimJae I. KimVictor KongKonstantinos LasithiotakisPedro LeãoMiguel LeonAndrey LitvinVarut LohsiriwatEudaldo López-Tomassetti FernandezEftychios LostoridisJames MacielPiotr MajorAna DimovaDimitrios ManatakisAthanasio MarinisAleix Martinez-PerezSanjay MarwahMichael McFarlaneCristian MesinaMichał PędziwiatrNickos MichalopoulosEvangelos MisiakosAli MohamedahmedRadu MoldovanuGiulia MontoriRaghuveer Mysore NarayanaIonut NegoiIoannis NikolopoulosGiuseppe NovelliViktors NovikovsIyiade OlaoyeAbdelkarim OmariCarlos A. OrdoñezMouaqit OuadiiZeynep OzkanAjay PalGian M. PaliniLars I. ParteckeFrancesco PataGerson A. Pereira JúniorTadeja PintarMagdalena PisarskaCesar F. Ploneda-ValenciaKonstantinos PouggourasVinod PrabhuPadmakumar RamakrishnapillaiJean-Marc RegimbeauMarianne ReitzDaniel Rios-CruzSten SaarBoris SakakushevCharalampos SeretisAlexander SazhinVishal ShelatMatej SkrovinaDmitry SmirnovCharalampos SpyropoulosMarcin StrzałkaPeep TalvingRicardo A. Teixeira GonsagaGeorge TheobaldGia TomadzeMyftar TorbaCristian TranàJan UlrychMustafa Y. UzunoğluAlin VasilescuSavino OcchionorelliAurélien VenaraAndras VereczkeiNereo VettorettoNutu VladMaciej WalędziakTonguç U. YilmazKuo-Ching YuanCui YunfengJustas ZilinskasGérard GrelpoisFausto Catena
Source
World Journal of Emergency Surgery, Vol 13, Iss 1, Pp 1-10 (2018)
Subject
Acute appendicitis
Diagnosis
Management
Surgery
Antibiotics
RD1-811
Medical emergencies. Critical care. Intensive care. First aid
RC86-88.9
Language
English
ISSN
1749-7922
Abstract
Abstract Background Acute appendicitis (AA) is the most common surgical disease, and appendectomy is the treatment of choice in the majority of cases. A correct diagnosis is key for decreasing the negative appendectomy rate. The management can become difficult in case of complicated appendicitis. The aim of this study is to describe the worldwide clinical and diagnostic work-up and management of AA in surgical departments. Methods This prospective multicenter observational study was performed in 116 worldwide surgical departments from 44 countries over a 6-month period (April 1, 2016–September 30, 2016). All consecutive patients admitted to surgical departments with a clinical diagnosis of AA were included in the study. Results A total of 4282 patients were enrolled in the POSAW study, 1928 (45%) women and 2354 (55%) men, with a median age of 29 years. Nine hundred and seven (21.2%) patients underwent an abdominal CT scan, 1856 (43.3%) patients an US, and 285 (6.7%) patients both CT scan and US. A total of 4097 (95.7%) patients underwent surgery; 1809 (42.2%) underwent open appendectomy and 2215 (51.7%) had laparoscopic appendectomy. One hundred eighty-five (4.3%) patients were managed conservatively. Major complications occurred in 199 patients (4.6%). The overall mortality rate was 0.28%. Conclusions The results of the present study confirm the clinical value of imaging techniques and prognostic scores. Appendectomy remains the most effective treatment of acute appendicitis. Mortality rate is low.