Outcomes after appendectomy in children with acute appendicitis treated at a tertiary paediatric centre: results from a
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ORIGINAL ARTICLE
Outcomes after appendectomy in children with acute appendicitis treated at a tertiary paediatric centre: results from a retrospective cohort study Max Knaapen 1 & Paul van Amstel 1 & Tim van Amstel 1 & Sarah-May M. L. The 1 & Roel Bakx 1 & Ernest L. W. E. van Heurn 1 & Ramon R. Gorter 1 Received: 12 June 2020 / Accepted: 23 August 2020 # The Author(s) 2020
Abstract Purpose In general, an appendectomy is presumed to have a limited burden of disease. However, in current literature, reported complication rates vary. This study aims to provide additional insights in the incidence of post-appendectomy complications in children with acute appendicitis. Methods This retrospective cohort study included children (0–17 years old) that underwent appendectomy at our tertiary referral centre for suspected acute appendicitis (January 2011–December 2018). Children referred to our centre, and those that underwent non-operative treatment were excluded. Post-appendectomy complications were recorded from electronic medical charts using predefined definitions and classified as severe (Clavien-Dindo III–IV) or less severe (Clavien-Dindo I–II). Results A total of 131 children were included. Simple and complex appendicitis was diagnosed in 66 (50%) and 60 (46%) children, respectively. A non-inflamed appendix was seen in five (4%) children. One or more complications were identified in 33 (25%) patients. Eight (12%) children with simple appendicitis developed a complication, three of these were severe. In children with complex appendicitis, 23 (38%) children developed a complication, 14 of these were severe. Conclusion This study shows a high rate of complications compared with current literature, both in children with simple and complex appendicitis. This is probably the result of our definition of complications and being a tertiary referral centre receiving more severe appendicitis cases. However, these results still show that appendectomy is not always a routine procedure with only few complications. Substantiating the need to keep optimizing treatment for children with appendicitis. Keywords Appendicitis . Paediatric surgery . Appendectomy . Post-appendectomy complications
Introduction Acute appendicitis is a common gastrointestinal disease in children. Roughly one in every 13 people will be afflicted by appendicitis at some point in their life, and in around one-third of all people, this will be during childhood or adolescence [1]. In recent years, the classification of acute appendicitis into two types has become well established: simple Max Knaapen and Paul van Amstel contributed equally to this work. * Max Knaapen [email protected] 1
Department of Paediatric Surgery, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam & Vrije Universiteit Amsterdam, PO Box 22660, 1100DD Amsterdam, The Netherlands
appendicitis (or non-perforating/uncomplicated) and complex appendicitis (or necrotizing/perforating) [2]. The incidence of these two types varies significantly across ages. In the paediatric popu
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