Ciro Esposito, Fulvia Del Conte, Mariapina Cerulo, Vincenzo Coppola, Vincenzo Bagnara, Francesco Tedesco, Claudia Di Mento, Annalisa Chiodi, Giorgia Esposito, Chiara Boccarossa, Maria Escolino
{"title":"首次保守入路失败后腹腔镜间隔阑尾切除术安全有效治疗复杂阑尾炎:单中心经验。","authors":"Ciro Esposito, Fulvia Del Conte, Mariapina Cerulo, Vincenzo Coppola, Vincenzo Bagnara, Francesco Tedesco, Claudia Di Mento, Annalisa Chiodi, Giorgia Esposito, Chiara Boccarossa, Maria Escolino","doi":"10.1177/10926429251366867","DOIUrl":null,"url":null,"abstract":"<p><p><b><i>Background:</i></b> Following the COVID-19 pandemic, antibiotic therapy has become the first-line treatment for acute appendicitis (AA) in many centers. Interval appendectomy (IA) is often needed later due to symptom recurrence. This paper aimed to report our experience with early, unplanned laparoscopic IA (LIA) over the past 2 years. <b><i>Materials and Methods:</i></b> All patients with previous AA initially managed with antibiotics who underwent LIA due to symptom recurrence over the period January 2022-March 2024 were enrolled. Parameters assessed included patients' characteristics and operative outcomes. <b><i>Results:</i></b> The patient cohort included 40 girls and 31 boys, with a median age of 13.3 years (range 9-17). All LIAs were accomplished laparoscopically without conversions or intraoperative complications. The median operative time was 27 minutes (range 15-48). The appendix was ligated using two endoloops in 28/71 (39.4%) and resected using an automatic stapler in 43/71 (60.6%). A retrocecal appendix was found in 25/71 (35%), and adhesions between the appendix and the surrounding tissues in 31/71 (43%). Parasitic helminths were found in the lumen of the appendix in 5/71 (7%). Meckel's diverticulum was negative in all cases. The median hospitalization was 32 hours (range 26-50). No postoperative complications occurred. Pathology confirmed intramural inflammation with peri-appendiceal fibrosis in all patients. <b><i>Conclusions:</i></b> Our study confirms that early laparoscopic appendectomy is a safe and feasible option after failed nonoperative management of complicated appendicitis. All procedures were completed laparoscopically without complications. Given the presence of adhesions and retrocecal appendix in many cases, further studies are needed to refine optimal treatment strategies and timing.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"758-762"},"PeriodicalIF":1.1000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Laparoscopic Interval Appendectomy as Safe and Effective Treatment of Complicated Appendicitis after Failed Initial Conservative Approach: A Single-Center Experience.\",\"authors\":\"Ciro Esposito, Fulvia Del Conte, Mariapina Cerulo, Vincenzo Coppola, Vincenzo Bagnara, Francesco Tedesco, Claudia Di Mento, Annalisa Chiodi, Giorgia Esposito, Chiara Boccarossa, Maria Escolino\",\"doi\":\"10.1177/10926429251366867\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b><i>Background:</i></b> Following the COVID-19 pandemic, antibiotic therapy has become the first-line treatment for acute appendicitis (AA) in many centers. Interval appendectomy (IA) is often needed later due to symptom recurrence. This paper aimed to report our experience with early, unplanned laparoscopic IA (LIA) over the past 2 years. <b><i>Materials and Methods:</i></b> All patients with previous AA initially managed with antibiotics who underwent LIA due to symptom recurrence over the period January 2022-March 2024 were enrolled. Parameters assessed included patients' characteristics and operative outcomes. <b><i>Results:</i></b> The patient cohort included 40 girls and 31 boys, with a median age of 13.3 years (range 9-17). All LIAs were accomplished laparoscopically without conversions or intraoperative complications. The median operative time was 27 minutes (range 15-48). The appendix was ligated using two endoloops in 28/71 (39.4%) and resected using an automatic stapler in 43/71 (60.6%). A retrocecal appendix was found in 25/71 (35%), and adhesions between the appendix and the surrounding tissues in 31/71 (43%). Parasitic helminths were found in the lumen of the appendix in 5/71 (7%). Meckel's diverticulum was negative in all cases. The median hospitalization was 32 hours (range 26-50). No postoperative complications occurred. Pathology confirmed intramural inflammation with peri-appendiceal fibrosis in all patients. <b><i>Conclusions:</i></b> Our study confirms that early laparoscopic appendectomy is a safe and feasible option after failed nonoperative management of complicated appendicitis. All procedures were completed laparoscopically without complications. Given the presence of adhesions and retrocecal appendix in many cases, further studies are needed to refine optimal treatment strategies and timing.</p>\",\"PeriodicalId\":50166,\"journal\":{\"name\":\"Journal of Laparoendoscopic & Advanced Surgical Techniques\",\"volume\":\" \",\"pages\":\"758-762\"},\"PeriodicalIF\":1.1000,\"publicationDate\":\"2025-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Laparoendoscopic & Advanced Surgical Techniques\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/10926429251366867\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/8/6 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Laparoendoscopic & Advanced Surgical Techniques","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/10926429251366867","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/8/6 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"SURGERY","Score":null,"Total":0}
Laparoscopic Interval Appendectomy as Safe and Effective Treatment of Complicated Appendicitis after Failed Initial Conservative Approach: A Single-Center Experience.
Background: Following the COVID-19 pandemic, antibiotic therapy has become the first-line treatment for acute appendicitis (AA) in many centers. Interval appendectomy (IA) is often needed later due to symptom recurrence. This paper aimed to report our experience with early, unplanned laparoscopic IA (LIA) over the past 2 years. Materials and Methods: All patients with previous AA initially managed with antibiotics who underwent LIA due to symptom recurrence over the period January 2022-March 2024 were enrolled. Parameters assessed included patients' characteristics and operative outcomes. Results: The patient cohort included 40 girls and 31 boys, with a median age of 13.3 years (range 9-17). All LIAs were accomplished laparoscopically without conversions or intraoperative complications. The median operative time was 27 minutes (range 15-48). The appendix was ligated using two endoloops in 28/71 (39.4%) and resected using an automatic stapler in 43/71 (60.6%). A retrocecal appendix was found in 25/71 (35%), and adhesions between the appendix and the surrounding tissues in 31/71 (43%). Parasitic helminths were found in the lumen of the appendix in 5/71 (7%). Meckel's diverticulum was negative in all cases. The median hospitalization was 32 hours (range 26-50). No postoperative complications occurred. Pathology confirmed intramural inflammation with peri-appendiceal fibrosis in all patients. Conclusions: Our study confirms that early laparoscopic appendectomy is a safe and feasible option after failed nonoperative management of complicated appendicitis. All procedures were completed laparoscopically without complications. Given the presence of adhesions and retrocecal appendix in many cases, further studies are needed to refine optimal treatment strategies and timing.
期刊介绍:
Journal of Laparoendoscopic & Advanced Surgical Techniques (JLAST) is the leading international peer-reviewed journal for practicing surgeons who want to keep up with the latest thinking and advanced surgical technologies in laparoscopy, endoscopy, NOTES, and robotics. The Journal is ideally suited to surgeons who are early adopters of new technology and techniques. Recognizing that many new technologies and techniques have significant overlap with several surgical specialties, JLAST is the first journal to focus on these topics both in general and pediatric surgery, and includes other surgical subspecialties such as: urology, gynecologic surgery, thoracic surgery, and more.