Abstract:
BACKGROUND:Acute Appendicitis is the most common surgical presentation within Australia. Despite the increasing use of radiological investigations to aid clinical diagnosis, many appendectomies result in a histologically normal appendix. This study examines the histological negative appendicectomy rate (NAR) in a metropolitan hospital and determine factors associated with a negative appendicectomy (NA). METHODS:Patients who underwent emergency appendicectomy for suspected acute appendicitis at Logan Hospital, Australia, between February 2016 and March 2019 inclusive were included. Clinicopathologic and imaging variables were analysed for associations with NA. RESULTS:A total of 1241 patients underwent emergency appendicectomy of which 121 patients (9.8%) had a NA. The NAR for clinical diagnosis alone (no imaging) was 9.9%, 14.5% for ultrasonography alone and computed tomography scan alone was 4.9%. Univariate analysis revealed age <27 years (P < 0.001), absence of hypertension (P = 0.008), symptoms >48 hours (P < 0.001), absence of leucocytosis (P < 0.001), undergoing ultrasonography only (P < 0.001), undergoing computed tomography scan only (P < 0.001), macroscopically normal appendix (P < 0.001) and time to operation >24 hours (P < 0.001) were associated with NA. Multivariate analysis identified symptoms >48 h at presentation (odds ratio (OR) 1.98, 95% confidence interval (CI) 1.20-3.24; P = 0.007), absence of leucocytosis (OR 2.41, 95% CI 1.52-3.81; P < 0.001) and macroscopically normal appendix (OR 5.70, 95% CI 3.49-9.33; P < 0.001) to be associated with a NA. CONCLUSION:The NAR reported is lowest in an Australian institution. The identified predictors of NA will be useful in identifying patients who would truly benefit from an appendicectomy versus those would have a higher rate of NA who may be suitable to be treated non-operatively to be spared the unnecessary morbidity of surgery.
journal_name
ANZ J Surgjournal_title
ANZ journal of surgeryauthors
Mackay TG,Dissanayake B,Yuide PJ,Burstow MJ,Gundara JS,Chua TCdoi
10.1111/ans.16203subject
Has Abstractpub_date
2020-08-17 00:00:00eissn
1445-1433issn
1445-2197pub_type
杂志文章abstract:BACKGROUND:The purpose of this study was to clarify the post-operative prognosis of pancreatic head cancer with pathologic portal vein (PV) or superior mesenteric vein (SMV) invasion. METHODS:From May 1995 to December 2009, preoperative, intra-operative and post-operative data from 276 patients who underwent pancreati...
journal_title:ANZ journal of surgery
pub_type: 杂志文章
doi:10.1111/ans.12502
更新日期:2015-04-01 00:00:00
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journal_title:ANZ journal of surgery
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journal_title:ANZ journal of surgery
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doi:10.1111/j.1445-2197.2012.06198.x
更新日期:2013-07-01 00:00:00
abstract:BACKGROUND:This study aimed to (i) investigate the factors that influence donor and recipient decision making in adult-to-adult living donor liver transplantation (AALDLT); (ii) quantify the level of risk that would be acceptable to potential donors; and (iii) determine from whom an individual would be willing to recei...
journal_title:ANZ journal of surgery
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更新日期:2017-03-01 00:00:00
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journal_title:ANZ journal of surgery
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journal_title:ANZ journal of surgery
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更新日期:2019-06-01 00:00:00
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journal_title:ANZ journal of surgery
pub_type: 杂志文章,评审
doi:10.1111/ans.13946
更新日期:2017-05-01 00:00:00
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journal_title:ANZ journal of surgery
pub_type: 杂志文章,评审
doi:10.1111/j.1445-2197.2006.03727.x
更新日期:2006-05-01 00:00:00
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pub_type: 杂志文章
doi:10.1111/ans.16181
更新日期:2020-08-11 00:00:00
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journal_title:ANZ journal of surgery
pub_type: 杂志文章
doi:10.1111/j.1445-2197.2007.04028.x
更新日期:2007-04-01 00:00:00
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journal_title:ANZ journal of surgery
pub_type: 杂志文章
doi:10.1111/ans.15745
更新日期:2020-06-01 00:00:00
abstract::Chance meetings in the USA and in France lead to the realization of the potential for cholecystectomy to be performed laparoscopically. Outlined are the steps taken to learn the technique and perform the first such operation in Australia (with unusual circumstances), immediately followed by the introduction of audit a...
journal_title:ANZ journal of surgery
pub_type: 历史文章,杂志文章
doi:10.1111/j.1445-2197.2011.05898.x
更新日期:2011-12-01 00:00:00
abstract:BACKGROUND:The presence of tumour cells in the pleural lavage of lung cancer patients with no malignant pleural effusion is a negative prognosticator. In the present study we aimed to determine the lowest frequency of positive pleural lavage in lung cancer. METHODS:The study included 26 consecutive patients who underw...
journal_title:ANZ journal of surgery
pub_type: 杂志文章
doi:10.1111/j.1445-2197.2005.03355.x
更新日期:2005-05-01 00:00:00
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journal_title:ANZ journal of surgery
pub_type: 杂志文章
doi:10.1111/j.1445-2197.2010.05265.x
更新日期:2011-01-01 00:00:00
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journal_title:ANZ journal of surgery
pub_type: 杂志文章
doi:10.1111/ans.14251
更新日期:2018-07-01 00:00:00
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journal_title:ANZ journal of surgery
pub_type: 杂志文章
doi:10.1111/j.1445-2197.2008.04800.x
更新日期:2009-01-01 00:00:00
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journal_title:ANZ journal of surgery
pub_type: 杂志文章
doi:10.1111/ans.12602
更新日期:2015-03-01 00:00:00
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journal_title:ANZ journal of surgery
pub_type: 杂志文章
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更新日期:2002-07-01 00:00:00
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journal_title:ANZ journal of surgery
pub_type: 杂志文章
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更新日期:2020-12-14 00:00:00
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journal_title:ANZ journal of surgery
pub_type: 杂志文章
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更新日期:2002-06-01 00:00:00
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journal_title:ANZ journal of surgery
pub_type: 杂志文章
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更新日期:2016-06-01 00:00:00
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journal_title:ANZ journal of surgery
pub_type: 杂志文章
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更新日期:2018-04-01 00:00:00
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更新日期:2019-04-01 00:00:00
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pub_type: 杂志文章
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更新日期:2018-07-01 00:00:00
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journal_title:ANZ journal of surgery
pub_type: 杂志文章
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