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Histopathological Analysis as Support for the Applicaibility of Interval Appendectmy: A Single-Center Retrospective Study

Received: 6 February 2022    Accepted: 22 February 2022    Published: 3 March 2022
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Abstract

Background: The management of perforated appendicitis with abscess, including interval appendectomy, remains controversial. Materials and Methods: The study was a retrospective analysis of patients diagnosed as having perforated appendicitis with abscess who were treated in our hospital between April 2014 and December 2020. A total of 51 patients who underwent successful interval appendectomy protocol were included. Residual pathological inflammation in the resection specimens and the relationship between preoperative computed tomography imaging and residual inflammation findings were evaluated. Results: All patients who had successful interval appendectomy received laparoscopic appendectomy as an elective surgery. Postoperative complications included superficial surgical site infection in two patients (4%). Pathological assessment of the resection specimens of interval appendectomy revealed acute inflammation and chronic inflammation in 11 patients (22%) and 25 patients (49%), respectively. Preoperative computed tomography imaging showed elevated peri-appendiceal fat tissue concentration and residual abscesses in 11 patients (22%) and five patients (10%), respectively. Residual inflammation was significantly higher in patients who had exhibited elevated peri-appendiceal fat tissue concentration on preoperative computed tomography imaging. Conclusions: Despite the absence of abdominal pain or other inflammatory symptoms, 70% patients showed pathological evidence of ongoing inflammation even after 3 months of conservative treatment. Given the high percentage of resection specimens showing acute or chronic appendicitis, interval appendectomy should be performed for complete elimination of inflammation.

Published in Journal of Surgery (Volume 10, Issue 2)
DOI 10.11648/j.js.20221002.11
Page(s) 57-61
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Interval Appendectomy, Computed Tomography, Inflammation, Pathology

References
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[2] G. C. Garst, E. E. Moore, M. N. Banerjee, D. K. Leopold, C. C. Burlew, D. D. Bensard, W. L. Biffl, C. C. Barnett, J. L. Johnson, A. Sauaia, Acute appendicitis: a disease severity score for the acute care surgeon, J. Trauma Acute Care Surg. 74 (1) (2013) 32–36.
[3] J. Z. Lugo, D. V. Avgerinos, A. J. Lefkowitz, M. E. Seigerman, I. S. Zahir, A. Y. Lo, B. Surick, I. M. Leitman, Can interval appendectomy be justified following conservative treatment of perforated acute appendicitis?, J. Surg. Res. 164 (1) (2010) 91–94.
[4] K. S. You, D. H. Kim, H. Y. Yun, L. C. Jang, J. W. Choi, Y. J. Song, D. H. Ryu, The value of a laparoscopic interval appendectomy for treatment of a peri-appendiceal abscess: experience of a single medical center, Surg. Laparosc. Endosc. Percutan. Tech. 22 (2) (2012) 127–130.
[5] R. Kita, H. Hashida, D. Yamashita, H. Kinoshita, M. Kondo, S. Kaihara, Usefulness and cost-effectiveness of interval appendectomy for complicated appendicitis, J. Surg. 9 (3) (2021) 109–113.
[6] D. Puapong, S. L. Lee, P. I. Haigh, A. Kaminski, I. L. Liu, H. Applebaum, Routine interval appendectomy in children is not indicated, J. Pediatr. Surg. 42 (9) (2007) 1500–1503.
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[8] A. Al-Kurd, I. Mizrahi, Siam B, Kupietzky A, Hiller N, Beglaibter N, Eid A, Mazeh H: Outcomes of interval appendectomy in comparison with appendectomy for acute appendicitis. The Journal of surgical research 2018, 225: 90-94.
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[14] G. P. Wright, M. E. Mater, J. T. Carroll, J. S. Choy, M. H. Chung, Is there truly an oncologic indication for interval appendectomy?, Am. J. Surg. 209 (3) (2015) 442–446.
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  • APA Style

    Ryosuke Kita, Daisuke Yamashita, Koji Kitamura, Masato Kondo, Hiroyuki Kobayashi, et al. (2022). Histopathological Analysis as Support for the Applicaibility of Interval Appendectmy: A Single-Center Retrospective Study. Journal of Surgery, 10(2), 57-61. https://doi.org/10.11648/j.js.20221002.11

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    ACS Style

    Ryosuke Kita; Daisuke Yamashita; Koji Kitamura; Masato Kondo; Hiroyuki Kobayashi, et al. Histopathological Analysis as Support for the Applicaibility of Interval Appendectmy: A Single-Center Retrospective Study. J. Surg. 2022, 10(2), 57-61. doi: 10.11648/j.js.20221002.11

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    AMA Style

    Ryosuke Kita, Daisuke Yamashita, Koji Kitamura, Masato Kondo, Hiroyuki Kobayashi, et al. Histopathological Analysis as Support for the Applicaibility of Interval Appendectmy: A Single-Center Retrospective Study. J Surg. 2022;10(2):57-61. doi: 10.11648/j.js.20221002.11

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  • @article{10.11648/j.js.20221002.11,
      author = {Ryosuke Kita and Daisuke Yamashita and Koji Kitamura and Masato Kondo and Hiroyuki Kobayashi and Kenji Uryuhara and Hiroki Hashida and Satoshi Kaihara},
      title = {Histopathological Analysis as Support for the Applicaibility of Interval Appendectmy: A Single-Center Retrospective Study},
      journal = {Journal of Surgery},
      volume = {10},
      number = {2},
      pages = {57-61},
      doi = {10.11648/j.js.20221002.11},
      url = {https://doi.org/10.11648/j.js.20221002.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20221002.11},
      abstract = {Background: The management of perforated appendicitis with abscess, including interval appendectomy, remains controversial. Materials and Methods: The study was a retrospective analysis of patients diagnosed as having perforated appendicitis with abscess who were treated in our hospital between April 2014 and December 2020. A total of 51 patients who underwent successful interval appendectomy protocol were included. Residual pathological inflammation in the resection specimens and the relationship between preoperative computed tomography imaging and residual inflammation findings were evaluated. Results: All patients who had successful interval appendectomy received laparoscopic appendectomy as an elective surgery. Postoperative complications included superficial surgical site infection in two patients (4%). Pathological assessment of the resection specimens of interval appendectomy revealed acute inflammation and chronic inflammation in 11 patients (22%) and 25 patients (49%), respectively. Preoperative computed tomography imaging showed elevated peri-appendiceal fat tissue concentration and residual abscesses in 11 patients (22%) and five patients (10%), respectively. Residual inflammation was significantly higher in patients who had exhibited elevated peri-appendiceal fat tissue concentration on preoperative computed tomography imaging. Conclusions: Despite the absence of abdominal pain or other inflammatory symptoms, 70% patients showed pathological evidence of ongoing inflammation even after 3 months of conservative treatment. Given the high percentage of resection specimens showing acute or chronic appendicitis, interval appendectomy should be performed for complete elimination of inflammation.},
     year = {2022}
    }
    

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  • TY  - JOUR
    T1  - Histopathological Analysis as Support for the Applicaibility of Interval Appendectmy: A Single-Center Retrospective Study
    AU  - Ryosuke Kita
    AU  - Daisuke Yamashita
    AU  - Koji Kitamura
    AU  - Masato Kondo
    AU  - Hiroyuki Kobayashi
    AU  - Kenji Uryuhara
    AU  - Hiroki Hashida
    AU  - Satoshi Kaihara
    Y1  - 2022/03/03
    PY  - 2022
    N1  - https://doi.org/10.11648/j.js.20221002.11
    DO  - 10.11648/j.js.20221002.11
    T2  - Journal of Surgery
    JF  - Journal of Surgery
    JO  - Journal of Surgery
    SP  - 57
    EP  - 61
    PB  - Science Publishing Group
    SN  - 2330-0930
    UR  - https://doi.org/10.11648/j.js.20221002.11
    AB  - Background: The management of perforated appendicitis with abscess, including interval appendectomy, remains controversial. Materials and Methods: The study was a retrospective analysis of patients diagnosed as having perforated appendicitis with abscess who were treated in our hospital between April 2014 and December 2020. A total of 51 patients who underwent successful interval appendectomy protocol were included. Residual pathological inflammation in the resection specimens and the relationship between preoperative computed tomography imaging and residual inflammation findings were evaluated. Results: All patients who had successful interval appendectomy received laparoscopic appendectomy as an elective surgery. Postoperative complications included superficial surgical site infection in two patients (4%). Pathological assessment of the resection specimens of interval appendectomy revealed acute inflammation and chronic inflammation in 11 patients (22%) and 25 patients (49%), respectively. Preoperative computed tomography imaging showed elevated peri-appendiceal fat tissue concentration and residual abscesses in 11 patients (22%) and five patients (10%), respectively. Residual inflammation was significantly higher in patients who had exhibited elevated peri-appendiceal fat tissue concentration on preoperative computed tomography imaging. Conclusions: Despite the absence of abdominal pain or other inflammatory symptoms, 70% patients showed pathological evidence of ongoing inflammation even after 3 months of conservative treatment. Given the high percentage of resection specimens showing acute or chronic appendicitis, interval appendectomy should be performed for complete elimination of inflammation.
    VL  - 10
    IS  - 2
    ER  - 

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Author Information
  • Department of Surgery, Kobe City Medical Center General Hospital, Kobe, Japan

  • Department of Pathology, Kobe City Medical Center General Hospital, Kobe, Japan

  • Department of Surgery, Kobe City Medical Center General Hospital, Kobe, Japan

  • Department of Surgery, Kobe City Medical Center General Hospital, Kobe, Japan

  • Department of Surgery, Kobe City Medical Center General Hospital, Kobe, Japan

  • Department of Surgery, Kobe City Medical Center General Hospital, Kobe, Japan

  • Department of Surgery, Kobe City Medical Center General Hospital, Kobe, Japan

  • Department of Surgery, Kobe City Medical Center General Hospital, Kobe, Japan

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