Predictors of Failed Laparoscopic Appendectomy in Perforated Appendicitis
Journal of Acute Care Surgery
; (2): 59-64, 2018.
Article
de En
| WPRIM
| ID: wpr-717779
Bibliothèque responsable:
WPRO
ABSTRACT
PURPOSE: A recent internal review of a community-based hospital system revealed a 19.19% rate of conversion from a laparoscopic appendectomy to an open procedure. This study examined the preoperative risk factors for failed laparoscopic appendectomy requiring a conversion to a laparotomy. METHODS: A total of 198 patients presented with perforated appendicitis. Perforation was defined as a computed tomography (CT) scan interpretation, pathology findings, or surgical findings. Of these patients, 161 underwent a laparoscopic appendectomy or laparoscopy converted to an open procedure. The preoperative risk factors in the two groups were compared through a retrospective chart review. RESULTS: Through multivariant analysis, age greater than 45 was the greatest risk factor for the need to convert to an open procedure with an odds ratio (OR) of 3.51. A CT scan read of perforation was associated with a significant 2.65 OR. The C-reactive protein was 19.82 mg/L in the failed laparoscopic cases and 9.96 mg/L in the laparoscopic cases. CONCLUSION: Patients older than 45 years old with a CT radiologist's read of a perforation in multivariant analysis have an increased risk of failed laparoscopic surgery requiring conversion to open surgery.
Mots clés
Texte intégral:
1
Indice:
WPRIM
Sujet Principal:
Anatomopathologie
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Appendicectomie
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Appendicite
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Protéine C-réactive
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Tomodensitométrie
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Odds ratio
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Études rétrospectives
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Facteurs de risque
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Laparoscopie
/
Conversion en chirurgie ouverte
Type d'étude:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limites du sujet:
Humans
langue:
En
Texte intégral:
Journal of Acute Care Surgery
Année:
2018
Type:
Article