Meaningful standard of reference for appendiceal perforation: pathology, surgery, or both?
Annals of Surgical Treatment and Research
;
: 88-97, 2017.
Article
Dans Anglais
| WPRIM
| ID: wpr-79444
ABSTRACT
PURPOSE:
This retrospective study was aimed to determine if appendiceal perforation identified pathologically but not surgically is clinically meaningful.METHODS:
The study consists of 2 parts. First, we reviewed 74 studies addressing appendiceal perforation published in 2012 and 2013. Second, in a cross-sectional study, we classified 1,438 adolescents and adults (mean age, 29.3 ± 8.4 years; 785 men) with confirmed appendicitis as “nonperforation” (n = 1,083, group 1), “pathologically-identified perforation” (n = 55, group 2), “surgically-identified perforation” (n = 202, group 3), or “pathologically- and surgically-identified perforation” (n = 98, group 4). The 4 groups were compared for the frequency of laparoscopic appendectomy and the length of hospital stay using multivariable logistic regression analyses.RESULTS:
The reference standard for appendiceal perforation was frequently missing or inconsistent in the previous studies. Laparoscopic appendectomies were less frequent in groups 3 (52.5%, P = 0.001) and 4 (65%, P = 0.040) than in group 1 (70.7%), while group 2 (73%, P = 0.125) did not significantly differ from group 1. Median hospital stays were 2.9, 3.0, 5.1, and 6.0 days for groups 1–4, respectively. Prolonged hospital stay (≥3.7 days) was more frequent in groups 3 (77.7%, P < 0.001) and 4 (89%, P < 0.001) than in group 1 (23.4%), while group 2 (35%, P = 0.070) did not significantly differ from group 1.CONCLUSION:
We recommend using surgical rather than pathologic findings as the reference standard for the presence of appendiceal perforation in future investigations.
Texte intégral:
Disponible
Indice:
WPRIM (Pacifique occidental)
Sujet Principal:
Anatomopathologie
/
Appendicectomie
/
Appendicite
/
Modèles logistiques
/
Études transversales
/
Études rétrospectives
/
Durée du séjour
Type d'étude:
Étude observationnelle
/
Étude de prévalence
/
Étude pronostique
/
Facteurs de risque
Limites du sujet:
Adolescent
/
Adulte
/
Humains
langue:
Anglais
Texte intégral:
Annals of Surgical Treatment and Research
Année:
2017
Type:
Article
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