Appendicitis is defined as a condition of inflammation of
Appendix. It is classified as an emergency, in many required the
removal of the appendix. If burst, or perforate, spilling infectious
materials into the abdominal cavity can be life threatening.
III. Complications and Diseases associated to Appendicitis
Treatments
A. Treatment in conventional medicine perspective
1. Laparoscopic and Open Appendectomy
In the study using the data from the 2007 to 2009 Taiwan National Health Insurance
Research Database. The study sample included 65,339 patients,
hospitalized with a discharge diagnosis of acute appendicitis (33.8% underwent laparoscopic appendectomy).
A generalized estimated equation (GEE) was performed to explore the
relationship between the use of laparoscopy and 30-day re-admission.
Hierarchical linear regressions were performed to examine the
relationship between the use of laparoscopy, the length of stay (LOS),
and the cost per discharge, showed that a significantly lower proportion of patients undergoing laparoscopic
appendectomies were re-admitted within 30 days of their index appendectomy,
in comparison to patients undergoing open appendectomies (0.66% versus
1.925, p<0.001). Compared with patients undergoing open
appendectomies, patients undergoing laparoscopic appendectomies had a
shorter LOS (4.01 versus 5.33 days, p<0.001) and a higher cost per
discharge (NT$40,554 versus NT$38,509, p<0.001. In 2007, the average
exchange rate was US$1 = NT$31.0). GEE revealed that the odds ratio of
30-day readmission for patients undergoing laparoscopic appendectomy
was 0.38 (95% CI = 0.33-0.46) that of patients undergoing open
appendectomies, after adjusting for surgeon, hospital, and patient
characteristics, as well as for the clustering effect of particular
surgeons and the propensity score(35).
2. Draining an abscess before appendix surgery
If in case if your appendix has burst and an abscess has formed around it. In the study to analyze retrospectively our experience with this disease to value the results of drainage of the abscess
and appendectomy in one stage in presence of appendiceal abscesses,
showed that preoperative ultrasonography showed an accuracy of 85.7% in
detecting the presence of an abscess. Mean size of the abscesses were 5 cm (from a minimum of 3 cm to a maximum of 9 cm). The mean duration of surgical
operation was 48 minutes (min 35'-max 95'), with a mean in-hospital
stay of 6.2 days. Morbidity rate was 9% and was due in 75% of cases to
wound infection and in 25% of cases to wound dehiscence. Neither major
morbidity nor mortality were observed. In consideration of the results
the authors conclude that even in presence of an appendiceal abscess, appendectomy with abscess
drainage is not only a safe operation with a low morbidity rate but the
procedure of choice allowing a significative reduction of
hospitalization and health cost(36).
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Sources
(35) http://www.ncbi.nlm.nih.gov/pubmed/23874710
(36) http://www.ncbi.nlm.nih.gov/pubmed/9228826
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