Abstract:
BACKGROUND:Uncomplicated acute appendicitis has been managed traditionally by early appendicectomy. However, recently, there has been increasing interest in the potential for primary treatment with antibiotics, with studies finding this to be associated with fewer complications than appendicectomy. The aim of this study was to compare outcomes of antibiotic therapy with appendicectomy for uncomplicated acute appendicitis. METHOD:This meta-analysis of randomised controlled trials included adult patients presenting with uncomplicated acute appendicitis treated with antibiotics or appendicectomy. The primary outcome measure was complications. Secondary outcomes included treatment efficacy, hospital length of stay (LOS), readmission rate and incidence of complicated appendicitis. RESULTS:Five randomised controlled trials with a total of 1430 participants (727 undergoing antibiotic therapy and 703 undergoing appendicectomy) were included. There was a 39 % risk reduction in overall complication rates in those treated with antibiotics compared with those undergoing appendicectomy (RR 0.61, 95 % CI 0.44-0.83, p = 0.002). There was no significant difference in hospital LOS (mean difference 0.25 days, 95 % CI -0.05 to 0.56, p = 0.10). In the antibiotic cohort, 123 of 587 patients initially treated successfully with antibiotics were readmitted with symptoms suspicious of recurrent appendicitis. The incidence of complicated appendicitis was not increased in patients who underwent appendicectomy after "failed" antibiotic treatment (10.8 %) versus those who underwent primary appendicectomy (17.9 %). CONCLUSION:Increasing evidence supports the primary treatment of acute uncomplicated appendicitis with antibiotics, in terms of complications, hospital LOS and risk of complicated appendicitis. Antibiotics should be prescribed once a diagnosis of acute appendicitis is made or considered.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Rollins KE,Varadhan KK,Neal KR,Lobo DNdoi
10.1007/s00268-016-3561-7subject
Has Abstractpub_date
2016-10-01 00:00:00pages
2305-18issue
10eissn
0364-2313issn
1432-2323pii
10.1007/s00268-016-3561-7journal_volume
40pub_type
杂志文章,meta分析abstract::This study aimed (1) to develop a simple scoring system incorporating ultrasound (US) examination and clinical or laboratory predictors for increasing diagnostic accuracy in acute appendicitis (AA), and (2) to evaluate the performance of the scoring system as compared to that of previous models. Fifteen variables incl...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-005-7853-6
更新日期:2005-09-01 00:00:00
abstract:AIM:We evaluated the effectiveness and safety of a transanal tube placed for the prevention of anastomotic leakage after rectal surgery. METHODS:Between 2007 and 2011, a total of 243 patients underwent anterior resection using the double stapling technique for rectal cancer at our institution. We excluded 67 patients ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-013-2428-4
更新日期:2014-07-01 00:00:00
abstract:BACKGROUND:Treating large and extensive pilonidal sinus disease is a challenging task. Long-term reports on flaps suitable for coverage of large, wide, local-excision defects are sparse. We prospectively evaluated data with a minimum 1-year follow-up of the use of a single-sided, innervated, superior gluteal artery per...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-012-1639-4
更新日期:2012-09-01 00:00:00
abstract:BACKGROUND:Peritoneal adhesions are recognized as an important cause for patient morbidity, but complications related to adhesions occur relatively late after the original operation. Therefore preoperative consent may not adequately reflect the proportions of the problem. METHODS:A total of 200 patients admitted for i...
journal_title:World journal of surgery
pub_type: 杂志文章,多中心研究
doi:10.1007/s00268-008-9917-x
更新日期:2009-04-01 00:00:00
abstract::In a retrospective study the clinical course of 40 patients with symptomatic persistent or recurrent parathyroid cancer was analyzed in order to assess the value of aggressive surgical intervention. Recurrence was diagnosed after a median period of 33 months (1-228 months). Twenty-two patients had locoregional disease...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF00353773
更新日期:1994-07-01 00:00:00
abstract::Axillary clearance in node-negative breast cancer patients is performed only for staging and prognostic purposes. The sentinel node concept may provide an alternative conservative approach for these patients. This paper reports on the learning experience with lymphatic mapping involving the use of patent blue dye for ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689910054
更新日期:2000-03-01 00:00:00
abstract:BACKGROUND:This study is intended to ascertain if outcome of acute abdominal surgery among elderly patients with acute abdominal pain have improved. METHODS:Altogether 456 patients aged >65 years underwent emergency abdominal surgery between the years 2007 and 2009 in our hospital. After excluding emergency reoperatio...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-015-3207-1
更新日期:2015-12-01 00:00:00
abstract::Papillary thyroid carcinoma is a frequent thyroid cancer. Many factors have been reported to be of prognostic importance, but the significance of biologic factors suggesting aggressiveness and proliferating activity has not been sufficiently documented. Conventional prognostic factors such as age, extrathyroidal invas...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689900551
更新日期:1998-12-01 00:00:00
abstract::The eponym "Graves' disease" is usually applied to the condition of immunogenic hyperthyroidism, in no small part due to the promotion and influence of the French physician Armand Trousseau who wrote in 1862, "Du Goître Exophthalmique, ou Maladie de Graves." However, the distinguished Bath physician Caleb Hillier Parr...
journal_title:World journal of surgery
pub_type: 传,历史文章,杂志文章
doi:10.1007/s00268-009-0297-7
更新日期:2010-06-01 00:00:00
abstract::Nuss described a minimally invasive technique for correcting pectus excavatum in children. A curved stainless-steel bar is inserted behind the sternum through the chest cavity with the convex surface face down, then rotated 180 degrees to elevate the sternum and correct the deformity. The procedure gained wide accepta...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-002-6519-x
更新日期:2002-10-01 00:00:00
abstract:BACKGROUND:Team familiarity has been shown to be important for operative efficiency and number of complications, but it is unclear for which types of operations and for which team members familiarity matters the most. The objective of this study is to further our understanding of familiarity in the OR by quantifying th...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-020-05657-1
更新日期:2020-11-01 00:00:00
abstract::The safe and permissible limits of hepatectomy in obstructive jaundice patients and the usefulness of preoperative portal embolization (PE) for increasing the limit for safe hepatectomy were examined. We classified 416 patients with hepatectomy performed over 9 years under the following headings: normal liver function...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-004-7128-7
更新日期:2004-05-01 00:00:00
abstract:BACKGROUND:Strictures at the pharyngoesophageal junction represent a subgroup of corrosive esophageal strictures requiring a specialized management approach. Non-dilatable cricopharyngeal strictures need surgical intervention. We report the use of the sternocleidomastoid muscle myocutaneous inlay flap (SCMMIF) for reco...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-007-9120-5
更新日期:2007-08-01 00:00:00
abstract:BACKGROUND:Three decades of internal conflict in the North and East of Sri Lanka have taken a toll on the health care system in that area. METHODS:We proposed to quantify the current status of capacity to deliver emergency, anesthesia, and surgical interventions in the conflict affected areas of Sri Lanka. The World H...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-009-0254-5
更新日期:2010-03-01 00:00:00
abstract::Reported incidence rates of carcinoma in patients with achalasia and the prevalence of achalasia in patients with esophageal cancer vary widely in the literature. The prognosis of an "achalasia-carcinoma" is generally considered poor, although systematic studies assessing the incidence, prevalence, and prognosis of pa...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-001-0026-3
更新日期:2001-06-01 00:00:00
abstract:BACKGROUND:A recent analysis found bradycardia during laparoscopy as a potential early warning sign of cardiac arrest. Knowledge regarding bradycardia frequency and its consequences during laparoscopy is limited. METHODS:Using the computerized record database, files of 9915 patients undergoing laparoscopic surgery, be...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-019-04935-x
更新日期:2019-06-01 00:00:00
abstract::The aim of this study was to investigate the collagen matrix in recurrent inguinal hernias. Total ribonucleic acid (RNA) was extracted from skin fibroblasts of three groups (control group I = healthy skin; control group II = plain skin scar; recurrent inguinal hernia group = skin of recurrent inguinal hernias; each n ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-001-0239-5
更新日期:2002-04-01 00:00:00
abstract:INTRODUCTION:Hypocalcemia is a well-known complication after total thyroidectomy. Studies have indicated that the presence of low postoperative parathyroid hormone (PTH) levels can predict hypocalcemia. However, definitive study designs are lacking. The aim of this study was to determine whether postoperative PTH alone...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-017-4444-2
更新日期:2018-07-01 00:00:00
abstract:INTRODUCTION:Sentinel lymph node biopsy (SLNB) is the standard of care for staging N0 primary early breast cancers (EBC). Patients in developing countries mostly present with large (LOBC) or locally advanced cancers (LABC) and are treated with neo-adjuvant chemotherapy (NACT). Accuracy of SLNB in staging stage III N0 a...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-015-3222-2
更新日期:2016-07-01 00:00:00
abstract::Acute biliary pancreatitis is a serious complication of biliary calculous disease and is associated with significant morbidity and mortality. The role of endoscopic retrograde cholangiopancreatography (ERCP) in the management of acute biliary pancreatitis has been the focus of discussion in recent years. In addition, ...
journal_title:World journal of surgery
pub_type: 临床试验,杂志文章
doi:10.1007/s002689900207
更新日期:1997-02-01 00:00:00
abstract:BACKGROUND:The change in the route of food passage after pancreaticoduodenectomy (PD) is quite similar to the change after gastric bypass surgery; both procedures bypass the duodenum and directly connect to the distal jejunum. Moreover, both procedures result in resolution of type 2 diabetes mellitus. Therefore, more d...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-015-3157-7
更新日期:2015-11-01 00:00:00
abstract::The value of surgical resection for patients with chronic pancreatitis has been debated on account of persistent symptoms and the morbidity of the operative procedure, both immediate and delayed. This paper explores the consequence of pancreatoduodenectomy in 175 patients with chronic pancreatitis who were operated on...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-003-7239-6
更新日期:2003-11-01 00:00:00
abstract:BACKGROUND:Prior studies have examined the use of liver function tests (LFT) for predicting the presence of common bile duct (CBD) stones in chronic cholecystitis (CC) patients. It is currently unclear whether LFT are also useful for predicting CBD stones in patients with acute cholecystitis (AC). METHODS:Of 1059 pati...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-016-3517-y
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:The burden of emergency general surgery conditions is high in sub-Saharan Africa, and poor access to surgical care leads to poor patient outcomes. We examined the trends in mortality in patients presenting with an acute abdomen to a referral hospital. METHODS:A retrospective analysis of the prospectively co...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-020-05468-4
更新日期:2020-07-01 00:00:00
abstract::Trends are changing in the management of infants and children with indirect inguinal hernias. Advances in neonatal intensive care have resulted in the survival of many small premature infants who have a high incidence of inguinal hernia. The rate of incarceration, strangulation, and gonadal infarction in these babies ...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/BF01658863
更新日期:1989-09-01 00:00:00
abstract:BACKGROUND:It has been thirty years since Bianchi introduced the technique that made intestinal lengthening possible. The last three decades have seen lengthening procedures established as vital components of intestinal rehabilitation programs. The goal of the present study was to use a systematic literature review to ...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-012-1879-3
更新日期:2013-03-01 00:00:00
abstract::Of the 2790 patients with gastric carcinoma who underwent surgery between January 1978 and December 1993, there were 224 who underwent a D2 resection for cancer of the proximal third of the stomach. Survival in these patients was retrospectively analyzed with special reference to the survival benefit of pancreaticospl...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689900283
更新日期:1997-07-01 00:00:00
abstract:BACKGROUND:The aim of this study was to report on the application of a minimally invasive technique to the radical extirpation of primary and recurrent pilonidal disease. This technique does not require specific equipments, is ordinarily performed under local anesthesia on an outpatient basis, and provides optimal cosm...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-019-05313-3
更新日期:2020-04-01 00:00:00
abstract:BACKGROUND:Few studies in the literature have reported recovery data for different types of recurrent laryngeal nerve injuries (RLNIs). This study is the first attempt to classify RLNIs and rank them by severity. METHODS:This prospective clinical study analyzed 281 RLNIs in which a true loss of signal was identified b...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-016-3415-3
更新日期:2016-06-01 00:00:00
abstract::Surgical treatment of adenomas may become necessary when the base of the polyp is too wide for snaring, increasing the risk of incomplete removal or perforation of the bowel wall. Suspicion of malignancy may also indicate surgery. Multiple adenomas not controlled by snare polypectomy can be treated by colectomy. The d...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF01658955
更新日期:1991-01-01 00:00:00