Annals of Coloproctology

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Predictive Factors to Distinguish Between Patients With Noncomplicated Appendicitis and Those With Complicated Appendicitis: Tae Hyung Kim, Byung Sun Cho, Jae Hag Jung, Moon Soo Lee, Je Ho Jang, Chang Nam Kim; Ann Coloproctol. 2015;31(5):192-197. Published online October 31, 2015; DOI: https://doi.org/10.3393/ac.2015.31.5.192

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41 Web of Science
31 Citations

Purpose

Recently, randomized controlled trials have reported that conservative therapy can be a treatment option in patients with noncomplicated appendicitis. However, preoperative diagnosis of noncomplicated appendicitis is difficult. In this study, we determined predictive factors to distinguish patients with noncomplicated appendicitis from those with complicated appendicitis.

Methods

A total of 351 patients who underwent surgical treatment for acute appendicitis from January 2011 to December 2012 were included in this study. We classified patients into noncomplicated or complicated appendicitis groups based on the findings of abdominal computed tomography and pathology. We performed a retrospective analysis to find factors that could be used to discriminate between noncomplicated and complicated appendicitis.

Results

The mean age of the patients in the complicated appendicitis group (54.5 years) was higher than that of the patients in the noncomplicated appendicitis group (40.2 years) (P < 0.001), but the male-to-female ratios were similar. In the univariate analysis, the appendicocecal junction's diameter, appendiceal maximal diameter, appendiceal wall enhancement, periappendiceal fat infiltration, ascites, abscesses, neutrophil proportion, C-reactive protein (CRP), aspartate aminotransferase, and total bilirubin were statistically significant factors. However, in the multivariate analysis, the appendiceal maximal diameter (P = 0.018; odds ratio [OR], 1.129), periappendiceal fat infiltration (P = 0.025; OR, 5.778), ascites (P = 0.038; OR, 2.902), and CRP (P < 0.001; OR, 1.368) were statistically significant.

Conclusion

Several factors can be used to distinguish between noncomplicated and complicated appendicitis. Using these factors, we could more accurately distinguish patients with noncomplicated appendicitis from those with complicated appendicitis.

Citations

Citations to this article as recorded by

An Integrated Analysis of Emerging Predictive Models for Preoperative Prediction of Complicated Acute Appendicitis
Shijian Zhang, Wenhan Wu, Qifa Wang, Changtong Zeng, Weifeng Du, Jia He
World Journal of Surgery.2026;[Epub] CrossRef
Utilizing non-invasive biomarkers for early and accurate differentiation of uncomplicated and complicated acute appendicitis: a retrospective cohort analysis
Mehmet Torun, İsmail Ege Subaşı, Deniz Kol Özbay, Mehmet Ali Özbay, Hakan Özdemir
Scientific Reports.2025;[Epub] CrossRef
High Diagnostic Accuracy but Persistent Risk of Complicated Appendicitis: A Retrospective Analysis from Hail Province, Saudi Arabia
Alfatih Mohamed Ahmed Aljanib, Faisal Fawaz Alshammari, Fahad Maiyah Alshammari, Ali Ahmed Alqahtani, Bandar Alsaif, Jerold C. Alcantara, Abdulaziz Bin Ali Alshammari, Talal Alharazi
International Journal of Applied & Basic Medical Research.2025; 15(2): 85. CrossRef
Low-keV virtual monoenergetic images with rapid kilovoltage-switching DECT for differentiating complicated from uncomplicated appendicitis in adults
Dhanawin Wongsaengchan, Jitti Chatpuwaphat, Shanigarn Thiravit, Sasima Tongsai, Napakadol Noppakunsomboon, Rathachai Kaewlai
Abdominal Radiology.2025;[Epub] CrossRef
Predictive Value of Clinical and CT Scan Findings for Complicated Appendicitis: A Retrospective Analysis
Ahmed G Alsayaf Alghamdi, Saleh M Alzhrani, Amer Fayraq, Saif A Alzahrani
Cureus.2025;[Epub] CrossRef
Development and Validation of the Scoring System of Appendicitis Severity 2.0
Jochem C. G. Scheijmans, Wouter J. Bom, Umme Habiba Ghori, Anna A. W. van Geloven, Gerjon Hannink, Charles C. van Rossem, Lieke van de Wouw, Peter M. Huisman, Annemiek van Hemert, Rutger J. Franken, Steven J. Oosterling, Camiel Rosman, Lianne Koens, Jaap
JAMA Surgery.2024; 159(6): 642. CrossRef
Oxidative Stress Enzyme NOX1 Is a New and Important Biomarker for Childhood Appendicitis?
Veli Avci, Kemal Ayengin, Zubeyir Huyut, Mehmet Tahir Huyut, Lokman Soysal, Salim Bilici
Indian Journal of Surgery.2023; 85(5): 1139. CrossRef
Individual biomarkers in the blood are not yet applicable in diagnosing complicated appendicitis: A scoping review
Binyamin Sikander, Jacob Rosenberg, Siv Fonnes
The American Journal of Emergency Medicine.2023; 67: 100. CrossRef
Risk factors for prolonged hospitalization and delayed treatment completion after laparoscopic appendectomy in patients with uncomplicated acute appendicitis
Jiyoung Shin, Myong Hoon Ihn, Kyung Sik Kim, Sang Hyun Kim, Jihyoun Lee, Sangchul Yun, Sung Woo Cho
Annals of Coloproctology.2023; 39(1): 50. CrossRef
Application of Artificial Neural Network Models to Differentiate Between Complicated and Uncomplicated Acute Appendicitis
Hui-An Lin, Li-Tsung Lin, Sheng-Feng Lin
Journal of Medical Systems.2023;[Epub] CrossRef
A New Marker In The Diagnosis Of Acute Complicated Appendicitis In Adult Patients: Neutrophil/Albumin Ratio
Serdar SAHİN
Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi.2023; 56(2): 52. CrossRef
Predicting complicated appendicitis is possible without the use of sectional imaging—presenting the NoCtApp score
Jens Strohäker, Martin Brüschke, You-Shan Feng, Christian Beltzer, Alfred Königsrainer, Ruth Ladurner
International Journal of Colorectal Disease.2023;[Epub] CrossRef
Validation of scoring systems for the prediction of complicated appendicitis in adults using clinical and computed tomographic findings
Rathachai Kaewlai, Sasima Tongsai, Wanwarang Teerasamit, Dhanawin Wongsaengchan, Napakadol Noppakunsomboon, Pramuk Khamman, Anchisa Chatkaewpaisal, Piyaporn Apisarnthanarak
Insights into Imaging.2023;[Epub] CrossRef
Predictive scoring systems to differentiate between simple and complex appendicitis in children (PRE-APP study)
Paul van Amstel, Sarah-May M.L. The, Roel Bakx, Taco S. Bijlsma, Sophie M. Noordzij, Oumaima Aajoud, Ralph de Vries, Joep P.M. Derikx, L.W. Ernest van Heurn, Ramon R. Gorter
Surgery.2022; 171(5): 1150. CrossRef
Negative Appendicectomy Rate: Incidence and Predictors
Khaled Noureldin, Ali Asgar Hatim Ali, Mohamed Issa, Heer Shah, Bolu Ayantunde, Abraham Ayantunde
Cureus.2022;[Epub] CrossRef
Evaluation of radiological and temporal characteristics of acute appendicitis on the non-enhanced computed tomography images
Xuan Gao, Wei-Yong Sheng, Biao Chen, Wei-Yi Cheng, Bing-Qing Ma, Peng Xu, Mellisa Evelyn, Jin-Xiang Zhang
Abdominal Radiology.2022; 47(7): 2279. CrossRef
Meta-analysis of the clinical efficacy of laparoscopic appendectomy in the treatment of acute appendicitis
Guangzhe Zhang, Bo Wu
World Journal of Emergency Surgery.2022;[Epub] CrossRef
Predictors and management outcomes of perforated appendicitis in sub-Saharan African countries: A retrospective cohort study
Dereje Zewdu, Mekete Wondwosen, Temesgen Tantu, Tamiru Tilahun, Tewodros Teshome, Ahmed Hamu
Annals of Medicine & Surgery.2022;[Epub] CrossRef
Periappendiceal fat-stranding models for discriminating between complicated and uncomplicated acute appendicitis: a diagnostic and validation study
Hui-An Lin, Hung-Wei Tsai, Chun-Chieh Chao, Sheng-Feng Lin
World Journal of Emergency Surgery.2021;[Epub] CrossRef
Comparison of Outer Diameter of Appendix, C-reactive Protein, and Serum Bilirubin Levels in Complicated Versus Uncomplicated Appendicitis
Dhanish Parekh, Dinesh Jain, Saurabh Mohite, Deepak Phalgune
Indian Journal of Surgery.2020; 82(3): 314. CrossRef
A simple classification of peritoneal contamination in perforated appendicitis predicts surgery‐related complications
Jia J Wee, Chang J Park, York T Lee, Yee L Cheong, Rambha Rai, Shireen A Nah
Journal of Paediatrics and Child Health.2020; 56(2): 272. CrossRef
Irrigation Versus Suction Alone During Laparoscopic Appendectomy for Uncomplicated Acute Appendicitis
Tae Gyeong Lee, Soomin Nam, Hyung Soon Lee, Jin Ho Lee, Young Ki Hong, Jung Gu Kang
Annals of Coloproctology.2020; 36(1): 30. CrossRef
An observational study of innate immune responses in patients with acute appendicitis
Toon Peeters, Sandrina Martens, Valentino D’Onofrio, Mark H. T. Stappers, Jeroen C. H. van der Hilst, Bert Houben, Ruth Achten, Leo A. B. Joosten, Inge C. Gyssens
Scientific Reports.2020;[Epub] CrossRef
The value of ischemia-modified albumin and oxidative stress markers in the diagnosis of acute appendicitis in adults
Hakan Hakkoymaz, Selçuk Nazik, Muhammed Seyithanoğlu, Özlem Güler, Ahmet Rıza Şahin, Emrah Cengiz, Fatih Mehmet Yazar
The American Journal of Emergency Medicine.2019; 37(11): 2097. CrossRef
Systematic Review and Meta-Analysis of CT Features for Differentiating Complicated and Uncomplicated Appendicitis
Hae Young Kim, Ji Hoon Park, Yoon Jin Lee, Sung Soo Lee, Jong-June Jeon, Kyoung Ho Lee
Radiology.2018; 287(1): 104. CrossRef
Ischemia-modified albumin as a predictor of the severity of acute appendicitis
Murat Özgür Kılıç, Cem Emir Güldoğan, İlhan Balamir, Mesut Tez
The American Journal of Emergency Medicine.2017; 35(1): 92. CrossRef
Increased anatomic severity predicts outcomes
Matthew C. Hernandez, Johnathon M. Aho, Elizabeth B. Habermann, Asad J. Choudhry, David S. Morris, Martin D. Zielinski
Journal of Trauma and Acute Care Surgery.2017; 82(1): 73. CrossRef
Role of hematological parameters in prediction of complicated appendicitis
Hakan Ataş, Murat Ö. Kılıç, Serdar G. Terzioğlu, Bariş Saylam
Wiener klinische Wochenschrift.2017; 129(9-10): 369. CrossRef
International normalized ratio and serum C-reactive protein are feasible markers to predict complicated appendicitis
Maru Kim, Sung-Jeep Kim, Hang Joo Cho
World Journal of Emergency Surgery.2016;[Epub] CrossRef
Prolonged operative time in laparoscopic appendectomy: Predictive factors and outcomes
Byeong Geon Jeon, Hyuk Jung Kim, Kuk Hyun Jung, Sang Wook Kim, Jin Soo Park, Ki Ho Kim, Il Dong Kim, Sang-Jeon Lee
International Journal of Surgery.2016; 36: 225. CrossRef
Change in the Diagnosis of Appendicitis by Using a Computed Tomography Scan and the Necessity for a New Scoring System to Determine the Severity of the Appendicitis
Byung Wook Min
Annals of Coloproctology.2015; 31(5): 174. CrossRef

The Role of Hand-Assisted Laparoscopic Surgery in a Right Hemicolectomy for Right-Sided Colon Cancer: Sung Uk Bae, Jin Seok Park, Young Jin Choi, Min Ku Lee, Byung Sun Cho, Yoon Jung Kang, Joo Seung Park, Chang Nam Kim; Ann Coloproctol. 2014;30(1):11-17. Published online February 28, 2014; DOI: https://doi.org/10.3393/ac.2014.30.1.11

7,670 View
47 Download
14 Web of Science
11 Citations

Abstract PDF

Purpose

The purpose of this study is to evaluate the perioperative and long-term oncologic outcomes of hand-assisted laparoscopic surgery (HALS) and standard laparoscopic surgery (SLS) and assess the role of HALS in the management of right-sided colon cancer.

Methods

The study group included 53 patients who underwent HALS and 45 patients who underwent SLS for right-sided colon cancer between April 2002 and December 2008.

Results

The patients in each group were similar in age, American Society of Anesthesiologist (ASA) score, body mass index, and history of previous abdominal surgeries. Eight patients in the HALS group and no patient in the SLS group exhibited signs of tumor invasion into adjacent structures. No differences were noted in the time to return of normal bowel function, time to toleration of diet, lengths of hospital stay and narcotic usage, and rate of postoperative complications. The median incision length was longer in the HALS group (HALS: 7.0 cm vs. SLS: 4.8 cm, P < 0.001). The HALS group had a significantly higher pathologic TNM stage and significantly larger tumor size (HALS: 6.0 cm vs. SLS: 3.3 cm, P < 0.001). The 5-year overall, disease-free, and cancer-specific survival rates of the HALS and the SLS groups were 87.3%, 75.2%, and 93.9% and 86.4%, 78.0%, and 90.7%, respectively (P = 0.826, P = 0.574, and P = 0.826).

Conclusion

Although patients in the HALS group had more advanced disease and underwent more complex procedures than those in the SLS group, the short-term benefits and the oncologic outcomes between the two groups were comparable. HALS can, therefore, be considered an alternative to SLS for bulky and fixed right-sided colon cancer.

Citations

Citations to this article as recorded by

The terminal ileal vein approach: a novel and simple technique for locating the superior mesenteric vein and en bloc resection of the ileal mesentery in laparoscopic right hemicolectomy
Yi-Jun Liao, Si-Yuan Mi, Da Kang, Xin Tang, Gong Chen, Zhi-Zhong Pan, Rong-Xin Zhang
Updates in Surgery.2025; 77(8): 2311. CrossRef
Effect of postoperative complications on 5-year survival following laparoscopic surgery for resectable colorectal cancer: a retrospective study
Jae Eun Lee, Kyeong Eui Kim, Woon Kyung Jeong, Seong Kyu Baek, Sung Uk Bae
International Journal of Colorectal Disease.2024;[Epub] CrossRef
Right hemicolectomy: a network meta-analysis comparing open, laparoscopic-assisted, total laparoscopic, and robotic approach
Emanuele Rausa, Michael Eamon Kelly, Emanuele Asti, Alberto Aiolfi, Gianluca Bonitta, Luigi Bonavina
Surgical Endoscopy.2019; 33(4): 1020. CrossRef
Outcomes of open, laparoscopic, and hand-assisted laparoscopic surgeries in elderly patients with right colon cancers
Mingtian Wei, Xubing Zhang, Pingfan Ma, Wanbin He, Liang Bi, Ziqiang Wang
Medicine.2018; 97(35): e11907. CrossRef
Hand-assisted laparoscopic right hemicolectomy with complete mesocolic excision and central vascular ligation: a novel technique for right colon cancer
Qing-Bin Wu, Xiang-Bing Deng, Xu-Yang Yang, Bing-Chen Chen, Wan-Bin He, Tao Hu, Ming-Tian Wei, Zi-Qiang Wang
Surgical Endoscopy.2017; 31(8): 3383. CrossRef
Hand-assisted laparoscopic surgery versus laparoscopic right colectomy: a meta-analysis
Guosen Wang, Jianping Zhou, Weiwei Sheng, Ming Dong
World Journal of Surgical Oncology.2017;[Epub] CrossRef
Robotic Complete Mesocolic Excision and Intracorporeal Anastomosis Using a Robotic Stapler for Right-Sided Colon Cancer With Reduced-Port Access
Sung Uk Bae, Woon Kyung Jeong, Seong Kyu Baek
Diseases of the Colon & Rectum.2017; 60(4): 456. CrossRef
Advances in Laparoscopic Colorectal Surgery
James Michael Parker, Timothy F. Feldmann, Kyle G. Cologne
Surgical Clinics of North America.2017; 97(3): 547. CrossRef
Need for Reappraisal of Hand-Assisted Laparoscopic Surgery for Colorectal Diseases in the Era of Desiring Small Incisions
Chang-Nam Kim
Annals of Coloproctology.2017; 33(4): 119. CrossRef
Hand-Assisted Laparoscopic Surgery Versus Conventional Laparoscopic Surgery for Colorectal Cancer: A Systematic Review and Meta-Analysis
Xubing Zhang, Qingbin Wu, Tao Hu, Chaoyang Gu, Liang Bi, Ziqiang Wang
Journal of Laparoendoscopic & Advanced Surgical Techniques.2017; 27(12): 1251. CrossRef
Hand-Assisted Laparoscopic Right Colectomy: Is It Useful?
Hungdai Kim
Annals of Coloproctology.2014; 30(1): 1. CrossRef

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