Appendicitis in children: correlation between the surgical and histological diagnosis.

IF 1.5 3区医学 Q2 PEDIATRICS

Pediatric Surgery International Pub Date : 2024-10-04 DOI:10.1007/s00383-024-05846-2

Balazs Fadgyas, Georgina Monostori, Dorottya Ori, Peter Vajda

{"title":"Appendicitis in children: correlation between the surgical and histological diagnosis.","authors":"Balazs Fadgyas, Georgina Monostori, Dorottya Ori, Peter Vajda","doi":"10.1007/s00383-024-05846-2","DOIUrl":null,"url":null,"abstract":"Purpose: Study was designed in order to evaluate the discrepancies between surgical and histological diagnosis in pediatric acute appendicitis (AA) and to compare the outcomes of laparoscopic (LA) and open appendectomies (OA).Methods: In a retrospective observational cohort, AA patients were included under 18 years of age, operated between 2011 and 2020. Surgical diagnosis was defined by the operating surgeon. The histological findings were classified as uncomplicated and complicated AA. The LOS and complications were also statistically analyzed.Results: Altogether, 1444 patients were included. Significant strong correlation and a moderate to substantial agreement were found between the surgeon's and the histopathological findings in all appendectomy cases (weighted kappa value in OA: 0.633, LA: 0.639, total sample: 0.637). If the surgeon's diagnosis was less severe than the pathologist's, the LOS was 4 (3;7) days, whereas if the surgical diagnosis was correct, the LOS was 3 (3;5) days (p < 0.0001).Conclusions: In contrary to the literature, our study revealed a strong correlation and moderate agreement between the intraoperative and histopathological findings regarding the severity of AA. Complicated cases are distinctly recognizable during the surgery. In case the surgeon underestimates the severity of AA, the chance of complications is higher.Level of evidence: II.","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"40 1","pages":"262"},"PeriodicalIF":1.5000,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11452465/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pediatric Surgery International","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00383-024-05846-2","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PEDIATRICS","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose: Study was designed in order to evaluate the discrepancies between surgical and histological diagnosis in pediatric acute appendicitis (AA) and to compare the outcomes of laparoscopic (LA) and open appendectomies (OA).

Methods: In a retrospective observational cohort, AA patients were included under 18 years of age, operated between 2011 and 2020. Surgical diagnosis was defined by the operating surgeon. The histological findings were classified as uncomplicated and complicated AA. The LOS and complications were also statistically analyzed.

Results: Altogether, 1444 patients were included. Significant strong correlation and a moderate to substantial agreement were found between the surgeon's and the histopathological findings in all appendectomy cases (weighted kappa value in OA: 0.633, LA: 0.639, total sample: 0.637). If the surgeon's diagnosis was less severe than the pathologist's, the LOS was 4 (3;7) days, whereas if the surgical diagnosis was correct, the LOS was 3 (3;5) days (p < 0.0001).

Conclusions: In contrary to the literature, our study revealed a strong correlation and moderate agreement between the intraoperative and histopathological findings regarding the severity of AA. Complicated cases are distinctly recognizable during the surgery. In case the surgeon underestimates the severity of AA, the chance of complications is higher.

Level of evidence: II.

查看原文本刊更多论文

儿童阑尾炎：手术诊断与组织学诊断之间的相关性。

目的：本研究旨在评估小儿急性阑尾炎（AA）手术诊断与组织学诊断之间的差异，并比较腹腔镜阑尾切除术（LA）与开腹阑尾切除术（OA）的疗效：在一项回顾性观察队列中，纳入了2011年至2020年间接受手术的18岁以下AA患者。手术诊断由手术医生确定。组织学检查结果分为非复杂性和复杂性 AA。此外，还对住院时间和并发症进行了统计分析：结果：共纳入 1444 例患者。在所有阑尾切除术病例中，外科医生的诊断与组织病理学结果之间均存在显著的强相关性和中度至高度的一致性（加权卡帕值：OA：0.633；LA：0.639；总样本：0.637）。如果外科医生的诊断结果比病理学家的诊断结果轻，则患者的生命周期为 4 (3;7) 天，而如果手术诊断结果正确，则患者的生命周期为 3 (3;5) 天（P 结论：如果外科医生的诊断结果比病理学家的诊断结果轻，则患者的生命周期为 4 (3;7) 天，而如果手术诊断结果正确，则患者的生命周期为 3 (3;5) 天：与文献报道相反，我们的研究显示，术中和组织病理学检查结果与 AA 的严重程度之间存在很强的相关性和适度的一致性。并发症病例在手术过程中可明显识别。如果外科医生低估了 AA 的严重程度，出现并发症的几率就会更高：证据等级：II.

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Pediatric Surgery International 医学-外科

CiteScore

3.00

自引率

5.60%

发文量

215

审稿时长

3-6 weeks

期刊介绍： Pediatric Surgery International is a journal devoted to the publication of new and important information from the entire spectrum of pediatric surgery. The major purpose of the journal is to promote postgraduate training and further education in the surgery of infants and children. The contents will include articles in clinical and experimental surgery, as well as related fields. One section of each issue is devoted to a special topic, with invited contributions from recognized authorities. Other sections will include: -Review articles- Original articles- Technical innovations- Letters to the editor