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European Journal of Trauma and Emergency Surgery

Published in:

03-06-2021 | Computed Tomography | Review Article

High-volume center analysis and systematic review of stump appendicitis: solving the pending issue

Authors: María A. Casas, Nicolás H. Dreifuss, Francisco Schlottmann

Published in: European Journal of Trauma and Emergency Surgery | Issue 3/2022

Abstract

Purpose

Stump appendicitis (SA) is a rare long-term complication after laparoscopic appendectomy (LA) that can be associated with high morbidity due to delayed diagnosis. We aimed to determine the incidence, risk factors, diagnosis, and management of SA by reviewing our large cohort of LA and performing a systematic review of the literature.

Methods

We retrospectively reviewed data of all patients who developed SA after LA between 2006 and 2020. Demographics, peri-operative variables, and postoperative outcomes were analyzed. A systematic review of the PubMed/MEDLINE, Embase and GoogleScholar bibliographic databases was also performed to identify publications regarding SA following LA.

Results

A total of 2,019 patients underwent LA; 5 (0.25%) developed SA after a median of 292 days. The most common symptom at presentation was right lower quadrant pain. Four SA (80%) occurred in patients with a history of complicated appendicitis at index operation. All patients were diagnosed with computed tomography and underwent completion stump appendectomy by laparoscopy. No postoperative complications were recorded. A total of 55 studies with 76 cases of SA after LA were identified in the systematic review. Most SA (98.7%) underwent surgery: 52% by laparoscopic approach and 36% through an open approach. Stump appendectomy was performed in 94.4% cases and an extended resection in 5.6%.

Conclusion

Although SA is a rare complication after LA, a high index of clinical suspicious and imaging studies are key for early diagnosis and treatment. A laparoscopic resection of the inflamed appendiceal stump is feasible, safe, and highly effective. A minority of patients with severe cecum compromise may need extended resections or conversion to open surgery.

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Title: High-volume center analysis and systematic review of stump appendicitis: solving the pending issue
Authors: María A. Casas
Nicolás H. Dreifuss
Francisco Schlottmann
Publication date: 03-06-2021
Publisher: Springer Berlin Heidelberg
Keywords: Computed Tomography
Nausea
Laparoscopy
Computed Tomography
Appendicitis
Appendicitis
Appendectomy
Published in: European Journal of Trauma and Emergency Surgery / Issue 3/2022
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-021-01707-y

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

High-volume center analysis and systematic review of stump appendicitis: solving the pending issue

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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