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A retrospective observational study investigating whether retrocecal appendicitis associated with worse operative and postoperative outcomes than non-retrocecal appendicitis.
Acute appendicitis is the most common cause of acute abdomen requiring acute surgery. The prevalence of the retrocaecal position of the appendix varies significantly between studies from 14 to 36%. Appendectomy of a retrocecal appendix is generally considered to be more demanding procedure than appendectomy of appendices in other positions. The aim of this study is to investigate whether retrocaecal appendicitis is associated with a higher rate of perioperative complications and delayed diagnosis when compared with the other positions.
A retrospective analysis of prospectively collected data of patients undergoing surgery for signs of acute appendicitis from January 2015 to April 2020 at the University Hospital Kralovske Vinohrady. Two groups of patients were be formed: the retrocaecal group and the non-retrocaecal group.
The following data were recorded: sex, age, body mass index, length of hospital stay, abdominal drain placement, length of surgery, surgical approach (laparoscopic, open or converted), operative finding (normal appendix or catarrhal, phlegmonous, gangrenous, or perforated appendicitis), position of the appendix (retrocaecal or non-retrocaecal positions), histopathological findings (acute inflammation, chronic inflammation, appendiceal tumour or normal appendix), 30-day postoperative complications, 30-day postoperative mortality, symptoms (abdominal pain, nausea, vomiting, diarrhoea, body temperature above 37 degrees celsius, urological complaints and gynaecological complaints), duration of symptoms (from onset to surgery), serious comorbidities and diabetes mellitus.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Retrocaecal group | Patients who underwent surgery for signs of acute appendicitis and had intraoperative finding of the appendix located in the retrocaecal position. |
| |
| Non-retrocaecal group | Patients who underwent surgery for signs of acute appendicitis and had intraoperative finding of the appendix not located in the retrocaecal position. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Appendectomy | Procedure | Surgical procedure for removal of the appendix |
|
| Measure | Description | Time Frame |
|---|---|---|
| Number of patient with postoperative complications | surgical site infections, postoperative ileus, bleeding, internal complications, | 30 days after intervention (appendectomy) |
| Number of patient who undergo converted appendectomy | Conversion from laparoscopic to open appendectomy | during the surgery |
| Length of hospital stay | Length of hospital stay after the procedure in days | 30 days after intervention (appendectomy) |
| Duration of procedure | Duration of appendectomy in minutes | Throughout the study period (1/2015-4/2020) |
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Inclusion Criteria:
Exclusion Criteria:
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All patients of the treated at the department of surgery of the University Hospital Kralovske Vinohrady
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| Name | Affiliation | Role |
|---|---|---|
| Adam Whitley, MUDr. | Vascular surgery, University hospital Královské Vinohrady, Prague | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Adam Whitley | Prague | Prague | 13000 | Czechia |
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| ID | Term |
|---|---|
| D001064 | Appendicitis |
| ID | Term |
|---|---|
| D059413 | Intraabdominal Infections |
| D007239 | Infections |
| D005759 | Gastroenteritis |
| D005767 | Gastrointestinal Diseases |
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| ID | Term |
|---|---|
| D001062 | Appendectomy |
| ID | Term |
|---|---|
| D013505 | Digestive System Surgical Procedures |
| D013514 | Surgical Procedures, Operative |
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| D004066 |
| Digestive System Diseases |
| D002429 | Cecal Diseases |
| D007410 | Intestinal Diseases |