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2017 ; 23
(32
): 5849-5859
Nephropedia Template TP
gab.com Text
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English Wikipedia
Laparoscopic appendectomy for acute appendicitis: How to discourage surgeons
using inadequate therapy
#MMPMID28932077
Hori T
; Machimoto T
; Kadokawa Y
; Hata T
; Ito T
; Kato S
; Yasukawa D
; Aisu Y
; Kimura Y
; Sasaki M
; Takamatsu Y
; Kitano T
; Hisamori S
; Yoshimura T
World J Gastroenterol
2017[Aug]; 23
(32
): 5849-5859
PMID28932077
show ga
Acute appendicitis (AA) develops in a progressive and irreversible manner, even
if the clinical course of AA can be temporarily modified by intentional
medications. Reliable and real-time diagnosis of AA can be made based on findings
of the white blood cell count and enhanced computed tomography. Emergent
laparoscopic appendectomy (LA) is considered as the first therapeutic choice for
AA. Interval/delayed appendectomy at 6-12 wk after disease onset is considered as
unsafe with a high recurrent rate during the waiting time. However, this
technique may have some advantages for avoiding unnecessary extended resection in
patients with an appendiceal mass. Non-operative management of AA may be
tolerated only in children. Postoperative complications increase according to the
patient's factors, and temporal avoidance of emergent general anesthesia may be
beneficial for high-risk patients. The surgeon's skill and cooperation of the
hospital are important for successful LA. Delaying appendectomy for less than 24
h from diagnosis is safe. Additionally, a semi-elective manner (i.e., LA within
24 h after onset of symptoms) may be paradoxically acceptable, according to the
factors of the patient, physician, and institution. Prompt LA is mandatory for
AA. Fortunately, the Japanese government uses a universal health insurance
system, which covers LA.
free
free
free
