دورية أكاديمية
Low intra-operative diagnostic accuracy does not affect postoperative treatment of acute appendicitis.
العنوان: | Low intra-operative diagnostic accuracy does not affect postoperative treatment of acute appendicitis. |
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المؤلفون: | Vinck EE; Department of Surgery, El Bosque University, Associated with Dr. Horacio Oduber Hospitaal, Oranjestad, Aruba., Villarreal RA; Department of Surgery, El Bosque University, Los Cobos Medical Center, Bogotá, Colombia., Luna-Jaspe C; Department of Surgery, El Bosque University, Los Cobos Medical Center, Bogotá, Colombia., Cabrera LF; Department of Surgery, El Bosque University, Los Cobos Medical Center, Bogotá, Colombia., Peterson TF; Department of Surgery, Universitair Ziekenhuis Brussel, Jette, Belgie, Dr. Horacio Oduber Hospitaal, Oranjestad, Aruba., Bernal F; Department of Surgery, El Bosque University, Los Cobos Medical Center, Bogotá, Colombia., Roa CL; Department of Clinical Pathology, Universidad El Bosque, Bogotá, Colombia. |
المصدر: | Acta chirurgica Belgica [Acta Chir Belg] 2020 Dec; Vol. 120 (6), pp. 390-395. Date of Electronic Publication: 2019 Jul 16. |
نوع المنشور: | Journal Article |
اللغة: | English |
بيانات الدورية: | Publisher: Taylor & Francis Country of Publication: England NLM ID: 0370571 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 0001-5458 (Print) Linking ISSN: 00015458 NLM ISO Abbreviation: Acta Chir Belg Subsets: MEDLINE |
أسماء مطبوعة: | Publication: 2016- : London : Taylor & Francis Original Publication: Bruxelles : Acta Medica Belgica |
مواضيع طبية MeSH: | Appendectomy* , Postoperative Care*, Appendicitis/*diagnosis , Appendicitis/*etiology, Adult ; Appendicitis/surgery ; Female ; Humans ; Male ; Predictive Value of Tests ; Reproducibility of Results ; Retrospective Studies |
مستخلص: | Background: The intra-operative classification of appendicitis defines postoperative treatment. The correct designation can influence patient recovery, complications and hospital costs. Recent research has shown that intra-operative classification criteria varies among surgeons, and is not always the same as the pathologist's report. Classification accuracy can lower costs by preventing unnecessary treatment or sub-optimal interventions. Methods: During a period of 4 months, N = 133 appendix specimens were received and evaluated by the pathology department of a single teaching hospital. Five surgeons extracted the specimens and one experienced pathologist drew the histopathology reports. A comparison between the surgeons' classifications and the pathologist's was made. Classification accuracy was determined and statistical analyses was performed using chi-square, and p values were obtained. A p < 0.05 was considered significant. Results: A total of N = 133 specimens were obtained, 127 belonged to patients following emergency surgery due to acute abdominal pain; the other six were from elective hemi-colectomies for right colonic adenocarcinomas, and were not included. Of the 127 specimens analyzed, 14 (11%) were negative, 21 (16.5%) were edematous, 81 (63.7%) were phlegmonous and 11 (8.6%) were gangrenous. A total of 18 (14%) perforated appendices were also reported. Surgical accuracy was 60.6% ( N = 67) with a statistically significant p < 0.001. Only five patients with incorrect intraoperative classifications received unnecessary or lacked treatment. Conclusions: An overall accuracy of 60.6% is seen when the surgical classification is compared to the pathological classification. Although the surgeons' accuracy is low when comparing intra-operative versus histopathological classification, this variation in designation does not affect postoperative treatment significantly. |
فهرسة مساهمة: | Keywords: Appendicitis; appendectomy; inflammation accuracy |
تواريخ الأحداث: | Date Created: 20190717 Date Completed: 20210901 Latest Revision: 20210901 |
رمز التحديث: | 20221213 |
DOI: | 10.1080/00015458.2019.1642578 |
PMID: | 31307280 |
قاعدة البيانات: | MEDLINE |
تدمد: | 0001-5458 |
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DOI: | 10.1080/00015458.2019.1642578 |