Meaningful standard of reference for appendiceal perforation: pathology, surgery, or both?
- Title
- Meaningful standard of reference for appendiceal perforation: pathology, surgery, or both?
- Author
- 송순영
- Keywords
- Appendicitis; Perforation
- Issue Date
- 2017-08
- Publisher
- KOREAN SURGICAL SOCIETY
- Citation
- ANNALS OF SURGICAL TREATMENT AND RESEARCH, v. 93, no. 2, page. 88-97
- 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 <.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.
- URI
- https://www.astr.or.kr/DOIx.php?id=10.4174/astr.2017.93.2.88https://repository.hanyang.ac.kr/handle/20.500.11754/115302
- ISSN
- 2288-6575; 2288-6796
- DOI
- 10.4174/astr.2017.93.2.88
- Appears in Collections:
- COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
- Files in This Item:
- Meaningful standard of reference for appendiceal perforation pathology, surgery, or both.pdfDownload
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