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10.1007/s11605-021-04988-1

http://scihub22266oqcxt.onion/10.1007/s11605-021-04988-1
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suck abstract from ncbi


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pmid33772399      J+Gastrointest+Surg 2021 ; 25 (7): 1905-1915
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  • Rate of Application and Outcome of Non-operative Management of Acute Appendicitis in the Setting of COVID-19: Systematic Review and Meta-analysis #MMPMID33772399
  • Emile SH; Hamid HKS; Khan SM; Davis GN
  • J Gastrointest Surg 2021[Jul]; 25 (7): 1905-1915 PMID33772399show ga
  • BACKGROUND: Non-operative management (NOM) of acute appendicitis has been assessed in several studies before COVID-19 pandemic. This systematic review aimed to assess the extent of adoption, efficacy, and safety of NOM of acute appendicitis in the setting of COVID-19. METHODS: This was a PRISMA-compliant systematic review of the literature. Electronic databases and Google Scholar were queried for studies that applied NOM of acute appendicitis during COVID-19. The main outcome measures were the rates of NOM application during the pandemic as compared to the pre-pandemic period, failure and complication rates of NOM. Failure was defined as the need for appendectomy during NOM and complications included development of appendicular mass or abscess. RESULTS: Fourteen studies (2140 patients) were included. The male to female ratio was 1.44:1 and median age was 34. Nine hundred fifty-nine (44.8%) patients had a trial of NOM. The weighted mean rate of NOM application was 50.1% (95%CI: 29.8-70.5%). The application of NOM during the pandemic was significantly more likely than its application before COVID-19 (OR = 6.7, p < 0.001). The weight mean failure rate of NOM was 16.4% (95%CI: 9.4-23.4). NOM failure was more likely in children and patients with complicated appendicitis. The weighted mean complication rate after NOM was 4.5% (95%CI: 1.4-7.7). NOM had significantly lower odds for complications than appendectomy (OR = 0.36, p = 0.03). There was no mortality after application of NOM. CONCLUSION: NOM of acute appendicitis in the setting of COVID-19 may be a safe, short-term alternative to surgery with acceptably low failure and complication rates.
  • |*Appendicitis/epidemiology/surgery[MESH]
  • |*COVID-19[MESH]
  • |Adult[MESH]
  • |Appendectomy/adverse effects[MESH]
  • |Child[MESH]
  • |Female[MESH]
  • |Humans[MESH]
  • |Male[MESH]
  • |Pandemics[MESH]


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