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Review

Inflammatory/benign bowel disease

Clinical outcomes and optimal indications for nonoperative management of acute appendicitis in adult patients: a comprehensive literature review: Hyun Gu Lee, In Ja Park; Ann Coloproctol. 2025;41(2):107-118. Published online April 16, 2025; DOI: https://doi.org/10.3393/ac.2023.00192.0027

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Graphical Abstract Abstract PDF

Appendectomy as the standard treatment for acute appendicitis has been challenged by accumulating evidence supporting nonoperative management with antibiotics as a potential primary treatment. This review aimed to summarize the clinical outcomes and the optimal indications for nonoperative management of acute appendicitis in adults. Current evidence suggests that uncomplicated and complicated appendicitis have different pathophysiologies and should be treated differently. Nonoperative management for uncomplicated appendicitis was not inferior to appendectomy in terms of complications and length of stay, with less than a 30% failure rate at 1 year. The risk of perforation and postoperative complications did not increase even if nonoperative management failed. Complicated appendicitis with localized abscess or phlegmon could also be treated conservatively, with a success rate of more than 80%. An interval appendectomy following successful nonoperative management is recommended only for patients over the age of 40 years to exclude appendiceal malignancy. The presence of appendicoliths increased the risk of treatment failure and complications; thus, it may be an indication for appendectomy. Nonoperative management is a safe and feasible option for both uncomplicated and complicated appendicitis. Patients should be informed that nonoperative management may be a safe alternative to surgery, with the possibility of treatment failure.

Citations

Citations to this article as recorded by

Appendicolith in non-operative management of acute appendicitis: Implications for recurrence and future directions
Ju Tian
World Journal of Clinical Cases.2025;[Epub] CrossRef

Original Articles

Benign GI diease,Benign diesease & IBD,Surgical technique

Clinical outcomes of locking polymeric clip for laparoscopic appendectomy in patients with appendicitis: a retrospective comparison with loop ligature: Seokwon Kim, Byong Ho Jeon, Sang Sik Cho, Ui Sup Shin, Sun Mi Moon; Ann Coloproctol. 2022;38(2):160-165. Published online January 18, 2022; DOI: https://doi.org/10.3393/ac.2021.00598.0085

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4 Web of Science
4 Citations

Abstract PDF

Purpose
This study aimed to compare the clinical outcomes of laparoscopic appendectomy (LA) according to the method of appendiceal stump closure.
Methods
Patients who underwent LA for appendicitis between 2010 and 2020 were retrospectively reviewed. Patients were classified into locking polymeric clip (LPC) and loop ligature (LL) groups. Clinical outcomes were compared between the groups.
Results
LPC and LL were used in 188 (56.6%) and 144 patients (43.4%), respectively for appendiceal stump closure. No significant differences were observed in sex, age, comorbidities, and the severity of appendicitis between the groups. The median operative time was shorter in the LPC group than in the LL group (64.5 minutes vs. 71.5 minutes, P=0.027). The median hospital stay was longer in the LL group than in the LPC group (4 days vs. 3 days, P=0.020). Postoperative incidences of intraabdominal abscess and ileus were higher in the LL group than in the LPC group (4.2% vs. 1.1%, P=0.082 and 2.8% vs. 0%, P=0.035; respectively). The readmission rate was higher in the LL group than that in the LPC group (6.3% vs. 1.1%, P=0.012).
Conclusion
Using LPC for appendiceal stump closure during LA for appendicitis was associated with lower postoperative complication rate, shorter operative time, and shorter hospital stay compared to the use of LL. Operative time above 60 minutes and the use of LL were identified as independent risk factors for postoperative complications in LA. Therefore, LPC could be considered a more favorable closure method than LL during LA for appendicitis.

Citations

Citations to this article as recorded by

Fistula formation between urinary bladder and abdominal wall caused by bladder injury from surgical clips following laparoscopic appendectomy
Wei Zhou, Yong Suo, Tian-Yan Luo, Long-Gang Wang
Asian Journal of Surgery.2025; 48(6): 3926. CrossRef
Comparison of Polymer Clips Versus Endoloop Ligatures for Appendiceal Stump Closure in Laparoscopic Appendectomy
Madan Haravu Srikantegowda, Shilpashree Channasandra Shekar, Vinod Nayak S
Cureus.2025;[Epub] CrossRef
Comparison of polymeric clip and endoloop in laparoscopic appendectomy: A systematic review and meta-analysis
Aashish Kumar, Muhammad Saqlain Mustafa, Muhammad Ashir Shafique, Abdul Haseeb, Hussain Sohail Rangwala, Haimath Kumar, Burhanuddin Sohail Rangwala, Adarsh Raja, Sandesh Raja, Syed Muhammad Sinaan Ali
Surgery.2024; 176(5): 1329. CrossRef
Advantages of using a polymeric clip versus an endoloop during laparoscopic appendectomy in uncomplicated appendicitis: a randomized controlled study
Kil-yong Lee, Jaeim Lee, Youn Young Park, Seong Taek Oh
World Journal of Emergency Surgery.2023;[Epub] 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; Ann Coloproctol. 2023;39(1):50-58. Published online November 18, 2021; DOI: https://doi.org/10.3393/ac.2021.00773.0110

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3 Web of Science
4 Citations

Abstract PDF Supplementary Material

Purpose
We sought to identify the risk factors for prolonged hospitalization and delayed treatment completion after laparoscopic appendectomy in patients with uncomplicated acute appendicitis.
Methods
The study retrospectively analyzed 497 patients who underwent laparoscopic appendectomies for uncomplicated appendicitis between January 2018 and December 2020. The patients were divided into an early discharge group (≤2 days) and a late discharge group (>2 days) based on the length of hospital stay (LOS). The patients were also divided into uneventful and complicated groups according to the need for additional treatment after standard follow-up.
Results
Thirty-seven patients (7.4%) were included in the late discharge group. The mean LOS of the late discharge groups was 3.9 days. There were significant differences according to age, preoperative C-reactive protein (CRP), and operative time between the 2 groups. Only operative time was significantly associated with prolonged LOS in multivariate analysis. Thirty-five patients (7.0%) were included in the complicated group. The mean duration of treatment in the uneventful and complicated groups was 7.4 and 25.3 days, respectively. Significant differences existed between the uneventful and complicated groups in preoperative body temperature, preoperative CRP levels, maximal appendix diameter, and the presence of appendicoliths. In multivariate analysis, preoperative CRP levels and maximal appendix diameter were independent predictors of delayed treatment completion.
Conclusion
Shorter operative time is desirable to ensure minimal hospital stay in patients with uncomplicated appendicitis. Further efforts are needed to ensure that patients with uncomplicated appendicitis do not experience delayed treatment completion after laparoscopic appendectomies.

Citations

Citations to this article as recorded by

Association between preoperative neutrophil-to-lymphocyte ratio and length of stay in pediatric patients undergoing laparoscopic appendectomy: a retrospective cohort study
Ming Liu, Yunpeng Gou, Ping Yang
BMC Pediatrics.2025;[Epub] CrossRef
Comparative Outcomes of Immediate and Delayed Wound Closure Techniques in Appendectomies for Gangrenous Appendicitis
Anzar Usman, Esha Akbar, Aliha Mukhtar, Iqra Nasir, Usama Rehman, Adil Iqbal, Muhammad Umar Umar
DEVELOPMENTAL MEDICO-LIFE-SCIENCES.2024; 1(3): 18. CrossRef
Non-linear association between C-reactive protein levels and length of stay in pediatric appendicitis patients undergoing laparoscopic appendectomy
Ming Liu, Ping Yang, Yunpeng Gou
Frontiers in Pediatrics.2024;[Epub] CrossRef
Nomogram prediction model for length of hospital stay following laparoscopic appendectomy in pediatric patients: a retrospective study
Ming Liu, Ping Yang, Yunpeng Gou, Qiang Chen, Dong Xu
Frontiers in Pediatrics.2024;[Epub] CrossRef

Case Report

Benign GI diease,Rare disease & stoma

Impending Rupture With a Twisted Huge Appendiceal Mucocele Treated With Totally Laparoscopic Resection: A Case Series: Hong-min Ahn, Si-Hak Lee; Ann Coloproctol. 2021;37(Suppl 1):S34-S38. Published online June 29, 2021; DOI: https://doi.org/10.3393/ac.2020.00150.0021

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2 Web of Science
3 Citations

Abstract PDF

Torsion of the appendix is rare, and appendiceal mucocele can be one of its causes. The first case was of a 49-year-old man who visited the emergency room (ER) for abdominal pain. Abdominal computed tomography (CT) showed appendiceal mucocele with suspected torsion and rupture. The patient underwent laparoscopic exploration and appendectomy. The second case was of a 69-year-old man who visited the ER for epigastric pain. Abdominal CT showed suspicious appendiceal mucocele with ischemic change, indicating torsion of the appendix. The twisted appendix was successfully removed by laparoscopic exploration. An appendiceal mucocele is one of the causes of twisted appendix. With torsion, the mucocele can be diagnosed as rupture by ischemia which may lead to pseudomyxoma peritonei. For this reason, open laparotomy has traditionally been preferred. However, an unruptured appendiceal mucocele or impending rupture with torsion of the appendiceal mucocele can be treated with totally laparoscopic surgery.

Citations

Citations to this article as recorded by

Torsion of Low-Grade Appendiceal Mucinous Neoplasm (LAMN): A Case Report
Hideo Kidogawa, Ryo Nonomura, Keizaburou Maruyama, Takashi Okimoto, Kohji Okamoto
Cureus.2024;[Epub] CrossRef
Uncommon cause of acute appendiceal torsion mucocele
Munyaradzi Gift Nyandoro, Vignesh Kumar Palanisamy, Rajesh Kumar Singh
BMJ Case Reports.2022; 15(7): e249175. CrossRef
Benign multicystic mesothelioma of appendiceal origin treated by hyperthermic intraperitoneal chemotherapy: A case report
Suk Jun Lee, Ji Hae Nahm, Jeonghyun Kang, Seung Hyuk Baik, Eun Jung Park
International Journal of Surgery Case Reports.2022; 99: 107665. CrossRef

Original Article

Benign GI diease,Benign diesease & IBD,Postoperative outcome & ERAS,Minimally invasive surgery

Comparing the Postoperative Outcomes of Single-Incision Laparoscopic Appendectomy and Three Port Appendectomy With Enhanced Recovery After Surgery Protocol for Acute Appendicitis: A Propensity Score Matching Analysis: Won Jong Kim, Hyeong Yong Jin, Hyojin Lee, Jung Hoon Bae, Wooree Koh, Ji Yeon Mun, Hee Ju Kim, In Kyu Lee, Yoon Suk Lee, Chul Seung Lee; Ann Coloproctol. 2021;37(4):232-238. Published online September 30, 2020; DOI: https://doi.org/10.3393/ac.2020.09.15

8,063 View
118 Download
15 Web of Science
23 Citations

Abstract PDF

Purpose
The objective of this study was to compare the perioperative outcomes between single-incision laparoscopic appendectomy (SILA) and 3-port conventional laparoscopic appendectomy (CLA) in enhanced recovery after surgery (ERAS) protocol.
Methods
Of 101 laparoscopic appendectomy with ERAS protocol cases for appendicitis from March 2019 to April 2020, 54 patients underwent SILA with multimodal analgesic approach (group 1) while 47 patients received CLA with multimodal analgesic approach (group 2). SILA and CLA were compared with the single institution’s ERAS protocol. To adjust for baseline differences and selection bias, operative outcomes and complications were compared after propensity score matching (PSM).
Results
After 1:1 PSM, well-matched 35 patients in each group were evaluated. Postoperative hospital stays for patients in group 1 (1.2 ± 0.8 vs. 1.6 ± 0.8 days, P = 0.037) were significantly lesser than those for patients in group 2. However, opioid consumption (2.0 mg vs. 1.4 mg, P=0.1) and the postoperative scores of visual analogue scale for pain at 6 hours (2.4±1.9 vs. 2.8 ± 1.4, P = 0.260) and 12 hours (2.4 ± 2.0 vs. 2.9 ± 1.5, P = 0.257) did not show significant difference between the 2 groups.
Conclusion
SILA resulted in shortening the length of hospitalization without increase in complications or readmission rates compared to CLA with ERAS protocol.

Citations

Citations to this article as recorded by

Evolving Paradigms in Minimal Access Surgery: A Comprehensive Review of Single-Incision Laparoscopic Appendicectomy
Divyakant H Barot, Minesh Sindhal, Priyanka Aanandaka, Nidhi D Gheewala, Parmar Bhargav
Cureus.2026;[Epub] CrossRef
Meta-analysis of single-incision versus three-port laparoscopic appendectomy comparing operation time and postoperative pain
Kyung-Goo Lee, Min Ki Kim, Jong Seob Park, Areum Han, Seokyung Hahn
International Journal of Surgery.2026; 112(1): 1737. CrossRef
Swedish national guidelines for diagnosis and management of acute appendicitis in adults and children
Martin Salö, Catarina Tiselius, Anders Rosemar, Elin Öst, Sara Sohlberg, Roland E Andersson
BJS Open.2025;[Epub] CrossRef
Single-incision versus conventional multi-incision laparoscopic appendicectomy for suspected uncomplicated appendicitis
Ahmer Irfan, Ahsan Rao, Irfan Ahmed
Cochrane Database of Systematic Reviews.2025;[Epub] CrossRef
Perioperative outcomes of laparoscopic low anterior resection using ArtiSential® versus robotic approach in patients with rectal cancer: a propensity score matching analysis
I. K. Kim, C. S. Lee, J. H. Bae, S. R. Han, W. Alshalawi, B. C. Kim, I. K. Lee, D. S. Lee, Y. S. Lee
Techniques in Coloproctology.2024;[Epub] CrossRef
Challenging issues of implementing enhanced recovery after surgery programs in South Korea
Soo-Hyuk Yoon, Ho-Jin Lee
Anesthesia and Pain Medicine.2024; 19(1): 24. CrossRef
A Single Site Approach to Appendicitis: A Review of a Single Center
Yoshito Tsuji, Yujiro Nishizawa, Yuki Ozato, Akira Inoue, Yoshinori Kagawa
Nippon Daicho Komonbyo Gakkai Zasshi.2024; 77(3): 161. CrossRef
The “Hansol-roll” folding method for placement of self-gripping (ProGrip™) mesh in single-port inguinal hernia repair using ArtiSential®
Gwan Chul Lee, Dong Woo Kang, Choon Sik Chung, Chul Seung Lee
Asian Journal of Surgery.2024; 47(7): 3272. CrossRef
Comparison between liquid skin adhesive and wound closure strip for skin closure after subcuticular suturing in single-port laparoscopic appendectomy: a single-center retrospective study in Korea
Kyeong Eui Kim, Yu Ra Jeon, Sung Uk Bae, Woon Kyung Jeong, Seong Kyu Baek
Journal of Minimally Invasive Surgery.2024; 27(1): 14. CrossRef
Progress in Clinical Treatment of Uncomplicated Acute Appendicitis in Children
珊白
Advances in Clinical Medicine.2024; 14(04): 471. CrossRef
Single-incision laparoscopic total extraperitoneal inguinal-hernia repair using the new articulating instruments: A video vignette
Chul Seung Lee, Gwan Chul Lee, Choon Sik Chung, Dong Keun Lee
Asian Journal of Surgery.2024; 47(8): 3586. CrossRef
Single-incision versus conventional multi-incision laparoscopic appendicectomy for suspected uncomplicated appendicitis
Ahmer Irfan, Ahsan Rao, Irfan Ahmed
Cochrane Database of Systematic Reviews.2024;[Epub] CrossRef
Clinical Outcomes of Single-incision Laparoscopic Appendectomy Versus Conventional Laparoscopic Appendectomy in Adult Acute Appendicitis
SHINTARO KOHAMA, KUNIHIKO NAGAKARI, MASAKAZU OHUCHI, KAZUHIRO TAKEHARA, KUMPEI HONJO, SHUN ISHIYAMA, KIICHI SUGIMOTO, SHINICHI OKA, JIRO YOSHIMOTO, MASAKI FUKUNAGA, YOICHI ISHIZAKI, KAZUHIRO SAKAMOTO
Juntendo Medical Journal.2024; 70(6): 436. 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
A prospective randomized controlled study comparing patient-reported scar evaluation of single-port versus multiport laparoscopic appendectomy for acute appendicitis
Kyeong Eui Kim, In Soo Cho, Sung Uk Bae, Woon Kyung Jeong, Hyung Jin Kim, Seong Kyu Baek
Journal of Minimally Invasive Surgery.2023; 26(2): 55. CrossRef
The Latest Results and Future Directions of Research for Enhanced Recovery after Surgery in the Field of Colorectal Surgery
Min Ki Kim
The Ewha Medical Journal.2023;[Epub] CrossRef
Analyzing the conversion factors associated with switching from a single-incision, one-puncture procedure to a two-site, three-port procedure in pediatric laparoscopic appendectomy
Keisuke Yano, Mitsuru Muto, Toshio Harumatsu, Taichiro Nagai, Masakazu Murakami, Chihiro Kedoin, Ayaka Nagano, Mayu Matsui, Koshiro Sugita, Shun Onishi, Koji Yamada, Waka Yamada, Makoto Matsukubo, Tatsuru Kaji, Satoshi Ieiri
Journal of Pediatric Endoscopic Surgery.2022; 4(2): 49. CrossRef
Laparoscopic Appendectomy Using the Surgical-Glove Port Through an Umbilical Incision: A Single-Center Retrospective Study
Tran Que Son, Tran Hieu Hoc, Vu Duc Long, Tran Thanh Tung, Nguyen Minh Tuan, Bui Minh Hue, Nguyen Van Minh, Nguyen Toan Thang
Cureus.2022;[Epub] CrossRef
Single-port robotic totally extraperitoneal(TEP) inguinal hernia repair using the da Vinci SP platform: A video vignette
Dongjun Kim, Chul Seung Lee
Asian Journal of Surgery.2022; 45(10): 2062. CrossRef
Single-incision compared with conventional laparoscopy for appendectomy in acute appendicitis: a systematic review and meta-analysis
Changjia Li, Yukun Liu, Yumin Jiang, Yongjing Xu, Zhiwei Wang
International Journal of Colorectal Disease.2022; 37(9): 1925. CrossRef
Enhanced recovery after surgery pathways for patients undergoing laparoscopic appendectomy
Abhijit Nair, Hamed Humayid Mohammed Al-Aamri, Osama Azmy Ishaq, Parwez Waseemul Haque
Journal of Acute Disease.2022; 11(5): 173. CrossRef
Robot-Assisted Colorectal Surgery
Young Il Kim
The Ewha Medical Journal.2022;[Epub] CrossRef
Enhanced recovery after surgery: importance of compliance audits
Jung Hoon Bae
Journal of the Korean Medical Association.2021; 64(12): 820. CrossRef

Case Report

Malignant disease,Benign diesease & IBD,Rare disease & stoma

Actinomycosis of the Appendix Mimicking Cecal Tumor Treated by Single-Port Laparoscopic Approach: In Soo Cho, Sung Uk Bae, Hye Ra Jung, Kyung Sik Park, Woon Kyung Jeong, Seong Kyu Baek; Ann Coloproctol. 2021;37(2):125-128. Published online March 16, 2020; DOI: https://doi.org/10.3393/ac.2019.08.10.1

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5 Citations

Abstract PDF

Actinomycosis is an inflammatory disease with various clinical presentations including inflammation and formation of masses. There are several reports suggesting the infiltrative mass-like nature of actinomycosis that is misunderstood as a tumor. A 39-year-old male clinically presented with a fungating mass-like lesion during colonoscopy for healthcare screening. Biopsy was performed for the lesion, and chronic inflammation was diagnosed. Abdominal computed tomography (CT) suggested severe edematous changes in the appendix with an appendicolith, suspected chronic inflammation, and wall thickening of the cecal base, but malignancy could not be definitively ruled out. The patient underwent a laparoscopic single-port cecectomy based on the possibility of cecal cancer. The final biopsy was diagnosed as actinomycosis, and the patient was prescribed antibiotics and showed no recurrence in the follow-up CT scan. We present this rare case of mass-like appendiceal actinomycosis treated with the single-port laparoscopic method.

Citations

Citations to this article as recorded by

Appendiceal actinomycosis mimicking malignant tumor: a rare case report
Nathan Khabyeh-Hasbani, Sivan Zino, Elena Dima, Shmuel Avital
Annals of Medicine & Surgery.2024; 86(2): 1076. CrossRef
Laparoscopic Cecectomy for Diseases of the Appendix and Cecum
Muharrem Oner, Maher A. Abbas
Journal of Coloproctology.2023; 43(04): e256. CrossRef
Appendiceal actinomycosis presenting as acute appendicitis: A diagnostic and therapeutic challenge
SP Tendulkar, PA Jain, MG Mehta, S George
Journal of Postgraduate Medicine.2023; 69(1): 63. CrossRef
Benign multicystic mesothelioma of appendiceal origin treated by hyperthermic intraperitoneal chemotherapy: A case report
Suk Jun Lee, Ji Hae Nahm, Jeonghyun Kang, Seung Hyuk Baik, Eun Jung Park
International Journal of Surgery Case Reports.2022; 99: 107665. CrossRef
Abdominal Actinomycosis Abscess Presenting as an Isolated Gastrointestinal Pseudotumor
Danisa Clarrett, Jennifer Michelle Ray, Jason R. Taylor
ACG Case Reports Journal.2021; 8(11): e00672. CrossRef

Original Articles

Benign GI diease

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; Ann Coloproctol. 2020;36(1):30-34. Published online February 29, 2020; DOI: https://doi.org/10.3393/ac.2019.06.25

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6 Web of Science
8 Citations

Abstract PDF

Purpose
To compare the surgical outcomes of peritoneal irrigation versus suction alone during laparoscopic appendectomy and to identify the risk factors of surgical site infection in patients with uncomplicated acute appendicitis.
Methods
Data from patients with uncomplicated acute appendicitis between January 2014 and March 2016 were reviewed. We compared the irrigation and suction alone groups with regard to the following parameters: postoperative complication incidence rate, length of hospital stay, operation time, time to flatus, time to diet commencement, and duration of postoperative antibiotic.
Results
A total of 578 patients underwent laparoscopic appendectomy for uncomplicated acute appendicitis. Twenty-five patients were excluded from the analysis because of need for drain insertion, loss to follow-up, simultaneous surgery for another indication, presence of an appendix tumor, or pregnancy. A total of 207 patients (37.4%) had undergone irrigation, and 346 patients (62.6%) received suction alone during laparoscopic appendectomy. The preoperative fever rate was significantly higher in the irrigation group than in the suction alone group. Operative time was also significantly longer in the irrigation group than in the suction alone group (53.8 ± 18.5 minutes vs. 57.8 ± 21.4 minutes, P = 0.027). The postoperative complication rate was higher in the irrigation group than in the suction alone group (4.5% vs. 12.6%, P = 0.001). Multiple logistic regression analysis showed that irrigation and preoperative fever were risk factors for surgical site infection after laparoscopic appendectomy for uncomplicated acute appendicitis.
Conclusion
There is no advantage to irrigating the peritoneal cavity over suction alone during laparoscopic appendectomy for uncomplicated acute appendicitis. Irrigation may actually prolong the operative time and therefore be detrimental.

Citations

Citations to this article as recorded by

Wound Irrigation Prior to Closure During Routine Upper-Extremity Surgery: Is There a Difference in Wound Complications?
Marco Foreman, Isabella Amador, Arman Tabarestani, Kevin A. Hao, Jonathan Benjamin, Jed Casauay, Oluwaferanmi Dada, Persis Desai, Aaron Jennings, Adrienne Orriols, Reed Popp, Supreeya A. Saengchote, Anton Khlopas, Keegan Hones, Richard Hutchison, Jongmin
HAND.2025;[Epub] CrossRef
Establishment and validation of a nomogram for predicting postoperative intestinal adhesion in children with acute appendicitis
Dezhao Liu, Yuchi Wang, Liyun Sun, Lijia Pan, Junkui Wang, Ying Lu, Zhao Cui, Jingying Li, Hui Geng
BMC Pediatrics.2024;[Epub] CrossRef
Management of appendicitis: appendicectomy, antibiotic therapy, or both?
Elroy P. Weledji, Anutebeh V. Zisuh, Eleanore Ngounou
Annals of Medicine & Surgery.2023; 85(4): 897. CrossRef
Wound Irrigation Using Wet Gauze May Reduce Surgical Site Infection Following Laparoscopic Appendectomy
Abdullah Al-Sawat, Ji Yeon Mun, Sung Hoon Yoon, Chul Seung Lee
Frontiers in Surgery.2022;[Epub] CrossRef
To Reduce the Incidence of Postoperative Intraabdominal Abscess, the Application of Nonoperative Management Should be Circumspect Considering Patient Factors and the Nature of Acute Appendicitis
You Jin Lee, Kwang Hyun Yoon
Journal of Acute Care Surgery.2022; 12(3): 111. CrossRef
Effect and safety of peritoneal lavage for appendectomy: A meta-analysis
Yi-Ting Yen, El-Wui Loh, Ka-Wai Tam
The Surgeon.2021; 19(6): e430. CrossRef
A Novel Suction-and-Irrigation Laparoscopic Surgical Instrument: Internal Design and Preclinical Performance Evaluation
Sang Wook Yi
Journal of Medical Devices.2021;[Epub] CrossRef
Aspiration versus peritoneal lavage in appendicitis: a meta-analysis
Gloria Burini, Maria Chiara Cianci, Marco Coccetta, Alessandro Spizzirri, Salomone Di Saverio, Riccardo Coletta, Paolo Sapienza, Andrea Mingoli, Roberto Cirocchi, Antonino Morabito
World Journal of Emergency Surgery.2021;[Epub] CrossRef

Benign GI diease

Resident Learning Curve for Laparoscopic Appendectomy According to Seniority: Chang Woo Kim, Sook Young Jeon, Bomina Paik, Jun Woo Bong, Sang Hyun Kim, Suk-Hwan Lee; Ann Coloproctol. 2020;36(3):163-171. Published online February 14, 2020; DOI: https://doi.org/10.3393/ac.2019.07.20

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Abstract PDF

Purpose
To delineate the learning curve (LC) for laparoscopic appendectomy (LA) performed by residents according to seniority in training.
Methods
Between October 2015 and November 2016, 150 patients underwent LA by three residents (in their first, second, and third year of training) under supervision. The patients were non-randomly assigned to each resident. The data were reviewed and analyzed retrospectively from prospectively collected database. The perioperative outcomes were compared between the three residents including operation time, complication, conversion, and so on. The LCs were evaluated by the moving average method and cumulative sum control chart (CUSUM) for operation time and surgical completion.
Results
Baseline characteristics and perioperative outcomes were similar except for age and location of the appendix among the three groups. Operation time was not different among the three residents (43.9, 45.3, and 48.4 min for A, B, and C, respectively). The moving average method for operation time showed a decreasing tendency for all residents. CUSUM for operation time showed that the peak points occurred at the 24th, 18th, and 31st cases for resident A, B, and C, respectively. In terms of surgical failure, residents A, B, and C reached steady states after the 35th, 11th, and 16th cases, respectively. Perforation of the appendix base was the only risk factor for surgical failure.
Conclusion
The LC for LA by residents was 11-35 cases according to multidimensional statistical analyses. The accumulation of surgical experience of residents might affect the LC, especially for surgical completion rather than for operation time.

Citations

Citations to this article as recorded by

Comparative analysis of surgical outcomes of laparoscopic appendectomy performed by six surgeons with different subspecialties: a retrospective cohort study using risk-adjusted cumulative summation
Ji Hyeong Song, Inyoung Na, Song-Yi Kim, Youn Ju Lee, Sun Jong Han, Sang Il Youn, Sa-Hong Min, Jin Soo Kim
Annals of Surgical Treatment and Research.2025; 109(3): 207. CrossRef
The Influence of Surgical Teaching on Laparoscopic Cholecystectomy Outcomes: A Retrospective Propensity Score-Matched National Cohort Study
Joana Rodrigues Ribeiro, André Silva Alves, Pascal Probst, Samuel A. Käser, Christian Toso, Beat Moeckli
Journal of Surgical Education.2025; 82(11): 103744. CrossRef
Systematic review and meta-analysis comparing perioperative outcomes of emergency appendectomy performed by trainee vs trained surgeon
Theophilus TK. Anyomih, Thomas Jennings, Alok Mehta, J Robert O'Neill, Ioanna Panagiotopoulou, Stavros Gourgiotis, Elizabeth Tweedle, John Bennett, R Justin Davies, Constantinos Simillis
The American Journal of Surgery.2023; 225(1): 168. CrossRef
Graded operative autonomy in emergency appendectomy mirrors case-complexity: surgical training insights from the SnapAppy prospective observational study
Nathalie Young, Rebecka Ahl Hulme, Maximilian Peter Forssten, Lewis Jay Kaplan, Thomas Noel Walsh, Yang Cao, Shahin Mohseni, Gary Alan Bass, Alan Biloslavo, Hayato Kurihara, Isidro Martinez-Casas, Jorge Pereira, Arvid Pourlotfi, Éanna J. Ryan, Matti Tolon
European Journal of Trauma and Emergency Surgery.2023; 49(1): 33. CrossRef
Training curriculum in minimally invasive emergency digestive surgery: 2022 WSES position paper
Nicola de’Angelis, Francesco Marchegiani, Carlo Alberto Schena, Jim Khan, Vanni Agnoletti, Luca Ansaloni, Ana Gabriela Barría Rodríguez, Paolo Pietro Bianchi, Walter Biffl, Francesca Bravi, Graziano Ceccarelli, Marco Ceresoli, Osvaldo Chiara, Mircea Chiri
World Journal of Emergency Surgery.2023;[Epub] CrossRef
How does the number of training years in pediatric surgery affect appendectomy outcomes?
Carlos Delgado-Miguel, Miriam Miguel-Ferrero, María San Basilio, Carla Ramírez, Juan Camps, Francisco Hernández Oliveros
Pediatric Surgery International.2023;[Epub] CrossRef
Clinical outcomes of locking polymeric clip for laparoscopic appendectomy in patients with appendicitis: a retrospective comparison with loop ligature
Seokwon Kim, Byong Ho Jeon, Sang Sik Cho, Ui Sup Shin, Sun Mi Moon
Annals of Coloproctology.2022; 38(2): 160. CrossRef
Laparoscopic appendicectomy without the use of disposable materials - a low-cost alternative - 1,552 cases operated in 20 years
CARLOS EDUARDO DOMENE, PAULA VOLPE, ANDRÉ VALENTE SANTANA
Revista do Colégio Brasileiro de Cirurgiões.2022;[Epub] CrossRef
Learning curve in laparoscopic appendectomy: training strategy of laparoscopic surgery
Hyung Ook Kim
Annals of Coloproctology.2022; 38(3): 276. CrossRef
Factors Influencing the Difficulty and Need for External Help during Laparoscopic Appendectomy: Analysis of 485 Procedures from the Resident-1 Multicentre Trial
Stefano Cioffi, Andrea Spota, Michele Altomare, Stefano Granieri, Roberto Bini, Francesco Virdis, Federica Renzi, Elisa Reitano, Osvaldo Chiara, Stefania Cimbanassi
Journal of Personalized Medicine.2022; 12(11): 1904. CrossRef
Impact of COVID-19 on the care of acute appendicitis: a single-center experience in Korea
Chang Woo Kim, Suk-Hwan Lee
Annals of Surgical Treatment and Research.2021; 101(4): 240. CrossRef

Malignant disease

Increased Risk of Neoplasms in Adult Patients Undergoing Interval Appendectomy: Jungtak Son, Yong Jun Park, Sung Ryol Lee, Hyung Ook Kim, Kyung Uk Jung; Ann Coloproctol. 2020;36(5):311-315. Published online January 31, 2020; DOI: https://doi.org/10.3393/ac.2019.10.15.1

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Abstract PDF

Purpose
The low rate of recurrent appendicitis after initial nonsurgical management of complicated appendicitis supports the recently implemented strategy of omitting routine interval appendectomy. However, several reports have suggested an increased incidence rate of neoplasms in these patients. We aimed to identify the risk of neoplasms in the population undergoing interval appendectomy.
Methods
This study retrospectively analyzed consecutive cases of appendicitis that were treated surgically between January 2014 and December 2018 at a single tertiary referral center. Patients were divided into 2 groups depending on whether they underwent immediate or interval appendectomy. Demographics and perioperative clinical and pathologic parameters were analyzed.
Results
All 2,013 adults included in the study underwent surgical treatment because of an initial diagnosis of acute appendicitis. Of these, 5.5% (111 of 2,013) underwent interval appendectomy. Appendiceal neoplasm was identified on pathologic analysis in 36 cases (1.8%). The incidence of neoplasm in the interval group was 12.6% (14 of 111), which was significantly higher than that of the immediate group (1.2% [22 of 1,902], P < 0.001). Conclusion: The incidence rate of neoplasms was significantly higher in patients undergoing interval appendectomy. These findings should be considered when choosing treatment options after successful nonsurgical management of complicated appendicitis.

Citations

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Incidental appendiceal neoplasms in a multicenter registry of appendicitis management
Aksel D. Laudon, Brendin R. Beaulieu-Jones, Swetha Duraiswamy, Frank F. Yang, Elizabeth Chen, Dave R. Flum, Kasey Lerner, Heather L. Evans, Lauren Thompson, Faris K. Azar, Alex Charboneau, Vlad V. Simianu, Victoria Valdes, Chaitan Narsule, Sabrina E. Sanc
Surgery.2026; 190: 109879. CrossRef
True Incidence of Appendiceal Neoplasms in Patients Presenting with Complicated Appendicitis: A Call for a Revised Management Algorithm
Laleh Foroutani, Jaeyun Jane Wang, Shreyas Kiran, Han Yin, Joshua Myszewski, Suwayda Ali, Amir Ashraf Ganjouei, Kenzo Hirose, Carlos Corvera, Eric Nakakura, Adnan Alseidi, Mohamed Abdelgadir Adam
Annals of Surgical Oncology.2026;[Epub] CrossRef
Appendiceal Tumor Prevalence in Patients With Periappendicular Abscess
Roosa Salminen, Jenny Alajääski, Tero Rautio, Saija Hurme, Pia Nordström, Elisa Mäkäräinen, Elina Lietzén, Tarja Pinta, Marie Grönroos-Korhonen, Tuomo Rantanen, Jan Andersén, Anne Mattila, Jyrki Kössi, Antti Riikola, Hannu Paajanen, Markku Matikainen, Ves
JAMA Surgery.2025; 160(5): 526. CrossRef
Acellular mucin in neoplastic and non-neoplastic conditions of the lower gastrointestinal tract
Noureldien Darwish, Lynn Guo, Eundong Park, Hwajeong Lee
World Journal of Gastrointestinal Surgery.2025;[Epub] CrossRef
Is it Possible to Manage Appendicular Mass Without Surgery?
Muhammad Albahadili, Saif Mundher Ismael, Monaf Faik Al-Samarraee
Al-Rafidain Journal of Medical Sciences ( ISSN 2789-3219 ).2025; 9(2): 46. CrossRef
Can Appendiceal Neoplasms Be Predicted in Patients with Presumed Acute Appendicitis?
Şevki Pedük
European Journal of Therapeutics.2024; 30(2): 145. CrossRef
Beyond acute appendicitis: a single-institution experience of unexpected pathology findings after 989 consecutive emergency appendectomy
Pietro Fransvea, Caterina Puccioni, Gaia Altieri, Luca D’Agostino, Gianluca Costa, Giuseppe Tropeano, Antonio La Greca, Giuseppe Brisinda, Gabriele Sganga
Langenbeck's Archives of Surgery.2024;[Epub] CrossRef
Exploring the mysterious mucinous appendiceal neoplasm
Erika Hissong
Seminars in Diagnostic Pathology.2024; 41(5): 222. CrossRef
High Incidence of Appendiceal Neoplasms in the Elderly: A Critical Concern for Non-Surgical Treatment
Gizem Issin, Fatih Demir, Irem Guvendir Bakkaloglu, Diren Vuslat Cagatay, Hasan Aktug Simsek, Ismail Yilmaz, Ebru Zemheri
Medical Principles and Practice.2023; 32(6): 358. CrossRef
Benign multicystic mesothelioma of appendiceal origin treated by hyperthermic intraperitoneal chemotherapy: A case report
Suk Jun Lee, Ji Hae Nahm, Jeonghyun Kang, Seung Hyuk Baik, Eun Jung Park
International Journal of Surgery Case Reports.2022; 99: 107665. CrossRef
Risk of appendiceal neoplasm after interval appendectomy for complicated appendicitis: A systematic review and meta-analysis
Roberto Peltrini, Valeria Cantoni, Roberta Green, Ruggero Lionetti, Michele D'Ambra, Carolina Bartolini, Marcello De Luca, Umberto Bracale, Alberto Cuocolo, Francesco Corcione
The Surgeon.2021; 19(6): e549. CrossRef
Interval appendicectomy for complicated appendicitis: do not let your guard down!
R Peltrini, M Podda, S Di Saverio, U Bracale, F Corcione
British Journal of Surgery.2021; 108(9): e288. CrossRef
Modern Management of the Appendix
CPT Samuel Grasso, LTC Avery Walker
Surgical Clinics of North America.2021; 101(6): 1023. CrossRef

Benign GI diease, Functional outcomes

The Effects of Preoperative Pain Education on the Decision to Discharge Patients Following Single-Incision Laparoscopic Appendectomy: Ji Won Seo, Moon Jin Kim, Sung-Hoon Yoon, Kwang Yeol Paik, Sun Min Park, Won Kyung Kang, Dosang Lee, Chul Seung Lee; Ann Coloproctol. 2020;36(6):398-402. Published online January 24, 2020; DOI: https://doi.org/10.3393/ac.2020.01.16

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Abstract PDF Supplementary Material

Purpose
Few studies have analyzed the effects of preoperative pain education on the postoperative decision to discharge. The purpose of this study was to determine the effects of pain education and management on the decision to discharge patients after single-incision laparoscopic appendectomy (SILA).
Methods
We analyzed 135 patients who had undergone SILA for acute appendicitis between March 2017 and April 2018 in a single medical center. Of these, 72 patients (53.3%) had received preoperative pain education (group 1), and 63 (46.7%) had not (group 2). We compared perioperative outcomes and complications between the groups.
Results
Baseline characteristics of sex, age, body mass index, American Society of Anesthesiologist score, and systemic inflammation factors (neutrophil-lymphocyte ratio, C-reactive protein level) did not differ significantly between the groups. There were no postoperative complications for patients in either group. Perioperative consequences and pathologic findings were not significantly different between the groups; however, length of hospital was significantly shorter in group 1.
Conclusion
Preoperative pain education in relation to postoperative pain management influenced the decision to shorten the postoperative hospital length of stay after SILA.

Citations

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Perioperative outcomes of laparoscopic low anterior resection using ArtiSential® versus robotic approach in patients with rectal cancer: a propensity score matching analysis
I. K. Kim, C. S. Lee, J. H. Bae, S. R. Han, W. Alshalawi, B. C. Kim, I. K. Lee, D. S. Lee, Y. S. Lee
Techniques in Coloproctology.2024;[Epub] CrossRef
Effect of continuous wound infiltration on patients using intravenous patient-controlled analgesia for pain management after reduced-port laparoscopic colorectal surgery
Hyeon Deok Choi, Sung Uk Bae
Annals of Coloproctology.2024; 40(6): 564. CrossRef
Relationship Between Appendectomy Incidence and Computed Tomography Scans Based on Korean Nationwide Data, 2003–2017
Ki Bum Park, Jinwook Hong, Jong Youn Moon, Jaehun Jung, Ho Seok Seo
Journal of Korean Medical Science.2022;[Epub] CrossRef
Wound Irrigation Using Wet Gauze May Reduce Surgical Site Infection Following Laparoscopic Appendectomy
Abdullah Al-Sawat, Ji Yeon Mun, Sung Hoon Yoon, Chul Seung Lee
Frontiers in Surgery.2022;[Epub] CrossRef
Surgical rectus sheath block combined with multimodal pain management reduces postoperative pain and analgesic requirement after single-incision laparoscopic appendectomy: a retrospective study
Won Jong Kim, Ji Yeon Mun, Hee Ju Kim, Sung-Hoon Yoon, Seung-Rim Han, Jung Hoon Bae, In Kyu Lee, Yoon Suk Lee, Do Sang Lee, Chul Seung Lee
International Journal of Colorectal Disease.2021; 36(1): 75. CrossRef
Clinical effect of multimodal perioperative pain management protocol for minimally invasive colorectal cancer surgery: Propensity score matching study
Chul Seung Lee, Soo Ji Park, Sang Hyun Hong, Jung-Woo Shim, Min Suk Chae, Seung-Rim Han, Jung Hoon Bae, In Kyu Lee, Dosang Lee, Yoon Suk Lee, Seong Taek Oh
Asian Journal of Surgery.2021; 44(2): 471. CrossRef
Comparing the Postoperative Outcomes of Single-Incision Laparoscopic Appendectomy and Three Port Appendectomy With Enhanced Recovery After Surgery Protocol for Acute Appendicitis: A Propensity Score Matching Analysis
Won Jong Kim, Hyeong Yong Jin, Hyojin Lee, Jung Hoon Bae, Wooree Koh, Ji Yeon Mun, Hee Ju Kim, In Kyu Lee, Yoon Suk Lee, Chul Seung Lee
Annals of Coloproctology.2021; 37(4): 232. CrossRef

Patient-Controlled Nutrition After Abdominal Surgery: Novel Concept Contrary to Surgical Dogma: Hyung Ook Kim, Mingoo Kang, Sung Ryol Lee, Kyung Uk Jung, Hungdai Kim, Ho-Kyung Chun; Ann Coloproctol. 2018;34(5):253-258. Published online October 31, 2018; DOI: https://doi.org/10.3393/ac.2018.05.29

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Abstract PDF

Purpose
According to surgical dogma, patients who are recovering from general anesthesia after abdominal surgery should begin with a clear liquid diet, progress to a full liquid diet and then to a soft diet before taking regular meals. We propose patient-controlled nutrition (PCN), which is a novel concept in postoperative nutrition after abdominal surgery.
Methods
A retrospective pilot study was conducted to evaluate the feasibility and effects of PCN. This study was carried out with a total of 179 consecutive patients who underwent a laparoscopic appendectomy between August 2014 and July 2016. In the PCN group, diet was advanced depending on the choice of the patients themselves; in the traditional group, diet was progressively advanced to a full liquid or soft diet and then a regular diet as tolerated. The primary endpoints were time to tolerance of regular diet and postoperative hospital stay.
Results
Time to tolerance of a regular diet (P < 0.001) and postoperative hospital stay (P < 0.001) showed statistically significant differences between the groups. Multivariate analysis using linear regression showed that the traditional nutrition pattern was the only factor associated with postoperative hospital stay (P < 0.001). Multivariate analysis using logistic regression showed that traditional nutrition was the only risk factor associated with prolonged postoperative hospital stay (≥3 days).
Conclusion
After abdominal surgery, PCN may be a feasible and effective concept in postoperative nutrition. In our Early Recovery after Surgery program, our PCN concept may reduce the time to tolerance of a regular diet and shorten the postoperative hospital stay.

Citations

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Bilateral Exchange: Enteral Nutrition Clinical Decision Making in Pediatric Surgery Patients
Manisha B. Bhatia, Cassandra M. Anderson, Abdiwahab N. Hussein, Brian Opondo, Nereah Aruwa, Otieno Okumu, Sarah G. Fisher, Tasha Sparks Joplin, JoAnna L. Hunter-Squires, Brian W. Gray, Peter W. Saula
Journal of Surgical Research.2024; 295: 139. CrossRef
Clinical pharmacist intervention in Appendectomy - Dexmedetomidine as an adjunct therapy ‎
Bushra Abdel-Hadi, Sami Raid Abdel-Fattah
Journal Of Advanced Pharmacy Education And Research.2022; 12(2): 1. CrossRef
外科患者の栄養管理における給食の意義

The Japanese Journal of SURGICAL METABOLISM and NUTRITION.2021; 55(2): 57. CrossRef

Is a One Night Delay of Surgery Safe in Patients With Acute Appendicitis?: Jae Min Lee, Beom Seok Kwak, Young Jin Park; Ann Coloproctol. 2018;34(1):11-15. Published online February 28, 2018; DOI: https://doi.org/10.3393/ac.2018.34.1.11

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20 Citations

Abstract PDF

Purpose

With varied reports on the impact of time to appendectomy on clinical outcomes, the purpose of this study was to determine the effect of preoperative in-hospital delay on the outcome for patients with acute appendicitis.

Methods

A retrospective review of 1,076 patients who had undergone an appendectomy between January 2010 and December 2013 was conducted.

Results

The outcomes of surgery and the pathologic findings were analyzed according to elapsed time. The overall elapsed time from onset of symptoms to surgery was positively associated with advanced pathology, increased number of complications, and prolonged hospital stay. In-hospital elapsed time was not associated with any advanced pathology (P = 0.52), increased number of postoperative complications (P = 0.14), or prolonged hospital stay (P = 0.24). However, the complication rate was increased when the in-hospital elapsed time exceeded 18 hours.

Conclusion

Advanced pathology and postoperative complication rate were associated with overall elapsed time from symptom onset to surgery rather than in-hospital elapse time. Therefore, a short-term delay of an appendectomy should be acceptable.

Citations

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Nigam’s scoring system: a reliable and accurate scoring system to diagnose acute appendicitis
Vinod Kumar Nigam, Siddharth Nigam
International Surgery Journal.2025; 12(3): 326. CrossRef
Influence of the Timing of Antibiotic Administration and Control of Infectious Foci on the Prognosis of Adult Patients with Critical Surgical Sepsis
Pedro M. Garrido Benedicto, Pitter F. Cueto Quintana, Juan Antonio Brito Piris, Elisabet Garcia Mañosa, Karla Malpica Basurto, Raquel Enriquez Sanchez, Immaculada Vallverdú Perapoch, Jordi Camps Andreu
The Journal of Emergency Medicine.2025; 75: 137. CrossRef
Early versus delayed laparoscopic appendectomy for acute uncomplicated appendicitis in adults: a systematic review and meta-analysis
Iftikhar Khan, Soban Ali Qasim, Haris Mumtaz Malik, Muhammad Hamza, Umna Bhatti, FNU Sawaira, Syeda Wania Haider, Saad Khan, Ehsanullah Alokozay, Muhammad Abdullah Ali, Fariha Hasan, Muhammad Riyyan
BMC Surgery.2025;[Epub] CrossRef
Is the performance of acute appendectomy at different times of day equal, in terms of postoperative complications, readmission, death, and length of hospital stay? A Swedish retrospective cohort study of 4950 patients
Petter Nyström, Martin Nordberg, Lennart Boström
European Journal of Trauma and Emergency Surgery.2024; 50(3): 791. CrossRef
Does the timing of appendectomy affect outcomes and postoperative complications?
María San Basilio, Carlos Delgado-Miguel, Carla Ramírez-Amorós, María Sarmiento, Lucas Moratilla-Lapeña, Arturo Almeyda, Ricardo Mejía, Leopoldo Martínez
Pediatric Surgery International.2023;[Epub] CrossRef
Timing of surgical operation for patients with intra-abdominal infection: A systematic review and meta-analysis
Shu-Rui Song, Yang-Yang Liu, Yu-Ting Guan, Ruo-Jing Li, Lei Song, Jing Dong, Pei-Ge Wang
World Journal of Gastrointestinal Surgery.2023; 15(10): 2320. CrossRef
Patient Outcomes Related to In-Hospital Delays in Appendicectomy for Appendicitis: A Retrospective Study
Oliver Claydon, Billy Down, Sidharth Kumar
Cureus.2022;[Epub] CrossRef
Possibility for avoidance of urgent nighttime operations for acute appendicitis in a regional core university hospital
Tomoya Tago, Mitsugi Shimoda, Ryosuke Imazato, Ryutaro Udou, Kenji Katsumata, Akihiko Tsuchida, Shuji Suzuki
Asian Journal of Endoscopic Surgery.2022; 15(1): 22. CrossRef
Daytime versus nighttime laparoscopic appendectomy in term of complications and clinical outcomes: A retrospective study of 1001 appendectomies
Amjad A. Shah, Raed M. Al-Zoubi, Ahmad R. Al-Qudimat, Mohamed Amine Rejeb, Laxmi Kumari Ojha, Sharif Abdulzem, Khadija Qadir, Sara Sameer, Ahmad Zarour, Mohamed Said Ghali
Heliyon.2022; 8(12): e11911. CrossRef
Nighttime Appendectomy is Safe and has Similar Outcomes as Daytime Appendectomy: A Study of 1198 Appendectomies
T. Mönttinen, H. Kangaspunta, J. Laukkarinen, M. Ukkonen
Scandinavian Journal of Surgery.2021; 110(2): 227. CrossRef
Revisiting delayed appendectomy in patients with acute appendicitis
Jian Li
World Journal of Clinical Cases.2021; 9(20): 5372. CrossRef
Laparoscopic Appendectomy in the Days of COVID-19
Roi Abramov, Mariya Neymark, Asaf Harbi, Hayim Gilshtein
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques.2021; 31(5): 599. CrossRef
Did the COVID-19 Pandemic Prolong the Time Till Diagnosis and Worsen Outcomes for Children with Acute Appendicitis?
Idilė Vansevičienė, Danielė Bučinskaitė, Dalius Malcius, Aušra Lukošiūtė-Urbonienė, Mindaugas Beržanskis, Emilis Čekanauskas, Vidmantas Barauskas
Medicina.2021; 57(11): 1234. CrossRef
Factors influencing surgical management of acute appendicitis in a large university hospital without a dedicated emergency theatre
Megan Power Foley, Michael MacLean, Ciaran Doyle, Timothy Nugent, Michael E. Kelly, Fady Narouz, Brian Mehigan, Paul McCormick, John Larkin
Irish Journal of Medical Science (1971 -).2020; 189(2): 649. CrossRef
Invited commentary on “Short-term outcome after appendectomy is related to preoperative delay but not to the time of day of the procedure: A nationwide retrospective cohort study of 9224 patients”
Xuan Liang, Yanxia Sun
International Journal of Surgery.2020; 79: 140. CrossRef
Quality Outcomes in Appendicitis Care: Identifying Opportunities to Improve Care
Syed Mohammad Umar Kabir, Magda Bucholc, Carol-Ann Walker, Opeyemi O. Sogaolu, Saqib Zeeshan, Michael Sugrue
Life.2020; 10(12): 358. CrossRef
Effect of Delay to Operation on Outcomes in Patients with Acute Appendicitis: a Systematic Review and Meta-analysis
Jian Li, Run Xu, Deng-Min Hu, Yao Zhang, Tu-Ping Gong, Xue-Lian Wu
Journal of Gastrointestinal Surgery.2019; 23(1): 210. CrossRef
Is postponed laparoscopic appendectomy justified for patients with acute appendicitis?
Atsushi Kohga, Kiyoshige Yajima, Takuya Okumura, Kimihiro Yamashita, Jun Isogaki, Kenji Suzuki, Katsuaki Muramatsu, Akira Komiyama, Akihiro Kawabe
Asian Journal of Endoscopic Surgery.2019; 12(4): 423. CrossRef
Is early appendectomy in adults diagnosed with acute appendicitis mandatory? A prospective study
Salma Abu Foul, Ella Egozi, Ahmad Assalia, Yoram Kluger, Ahmad Mahajna
World Journal of Emergency Surgery.2019;[Epub] CrossRef
Preoperative Clinical Factors Associated with Short‐Stay Laparoscopic Appendectomy
Aurélie Vuagniaux, Olivier Gié, Fabio Butti, Pedro Manuel Marques‐Vidal, Nicolas Demartines, Styliani Mantziari
World Journal of Surgery.2019; 43(11): 2771. CrossRef

Unexpected Appendiceal Pathologies and Their Changes With the Expanding Use of Preoperative Imaging Studies: Hong Yeol Yoo, Jaewoo Choi, Jongjin Kim, Young Jun Chai, Rumi Shin, Hye Seong Ahn, Chang-Sup Lim, Hae Won Lee, Ki-Tae Hwang, In Mok Jung, Jung Kee Chung, Seung Chul Heo; Ann Coloproctol. 2017;33(3):99-105. Published online June 30, 2017; DOI: https://doi.org/10.3393/ac.2017.33.3.99

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Abstract PDF

Purpose

The preoperative diagnosis of acute appendicitis is often challenging. Sometimes, pathologic results of the appendix embarrass or confuse surgeons. Therefore, more and more imaging studies are being performed to increase the accuracy of appendicitis diagnoses preoperatively. However, data on the effect of this increase in preoperative imaging studies on diagnostic accuracy are limited. We performed this study to explore unexpected appendiceal pathologies and to delineate the role of preoperative imaging studies in the diagnosis of acute appendicitis.

Methods

The medical records of 4,673 patients who underwent an appendectomy for assumed appendicitis between 1997 and 2012 were reviewed retrospectively. Pathological results and preoperative imaging studies were surveyed, and the frequencies of pathological results and preoperative imaging studies were investigated.

Results

The overall rate of pathology compatible with acute appendicitis was 84.4%. Unexpected pathological findings, such as normal histology, specific inflammations other than acute appendicitis, neoplastic lesions, and other pathologies, comprised 9.6%, 3.3%, 1.2%, and 1.5%, respectively. The rate of unexpected pathological results was significantly reduced because of the increase in preoperative imaging studies. The decrease in normal appendices contributed the most to the reduction while other unexpected pathologies did not change significantly despite the increased use of imaging studies. This decrease in normal appendices was significant in both male and female patients under the age of 60 years, but the differences in females were more prominent.

Conclusion

Unexpected appendiceal pathologies comprised 15.6% of the cases. Preoperative imaging studies reduced them by decreasing the negative appendectomy rate of patients with normal appendices.

Citations

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Changing trends in appendiceal pathology: a 16-year retrospective extension study of surgically removed appendices in a tropical teaching hospital
Nicholas Awodele Awolola, Andrea Oludolapo Akinjo, AbdulRazzaq Oluwagbemiga Lawal, Kabir Bolarinwa Badmos, Fatimah Biade Abdulkareem
BMC Gastroenterology.2025;[Epub] CrossRef
The appendix: An unexpected band obstruction
Rowan Klein Nulend, Rakesh Quinn, Kar Yin Fok, Nimalan Pathmanathan
Journal of Case Reports and Images in Surgery.2024; 10(1): 1. CrossRef
The Vermiform Appendix and Its Pathologies
Marian Constantin, Livia Petrescu, Cristina Mătanie, Corneliu Ovidiu Vrancianu, Adelina-Gabriela Niculescu, Octavian Andronic, Alexandra Bolocan
Cancers.2023; 15(15): 3872. CrossRef
Rising incidence of appendiceal neoplasms over time: Does pathological handling of appendectomy specimens play a role?
Hisham F. Bahmad, Abed Alhalim Aljamal, Juan Carlos Alvarez Moreno, Ali Salami, Philip Bao, Sarah Alghamdi, Robert J. Poppiti
Annals of Diagnostic Pathology.2021; 52: 151724. CrossRef
The Impact of Pathological Criteria on Pediatric Negative Appendectomy Rate
Caroline Maloney, Morris C. Edelman, Alexandra C. Bolognese, Aaron M. Lipskar, Barrie S. Rich
Journal of Pediatric Surgery.2019; 54(9): 1794. CrossRef
Communication and management of incidental pathology in 1,214 consecutive appendicectomies; a cohort study
Ned Kinnear, Bridget Heijkoop, Eliza Bramwell, Alannah Frazzetto, Amy Noll, Prajay Patel, Derek Hennessey, Greg Otto, Christopher Dobbins, Tarik Sammour, James Moore
International Journal of Surgery.2019; 72: 185. CrossRef
Unexpected Appendiceal Pathologies and Preoperative Imaging Studies on Patients With Acute Appendicitis
Byung Chun Kim
Annals of Coloproctology.2017; 33(3): 82. CrossRef

Single-Port Laparoscopic Interval Appendectomy for Perforated Appendicitis With a Periappendiceal Abscess: Sung Uk Bae, Woon Kyung Jeong, Seong Kyu Baek; Ann Coloproctol. 2016;32(3):105-110. Published online June 30, 2016; DOI: https://doi.org/10.3393/ac.2016.32.3.105

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Abstract PDF

Purpose

Nonoperative management followed by an interval appendectomy is a commonly used approach for treating patients with perforated appendicitis with abscess formation. As minimally-invasive surgery has developed, single-port laparoscopic surgery (SPLS) is increasingly being used to treat many conditions. We report our initial experience with this procedure using a multichannel single-port.

Methods

The study included 25 adults who underwent a single-port laparoscopic interval appendectomy for perforated appendicitis with periappendiceal abscess by using a single-port with or without needlescopic grasper between June 2014 and January 2016.

Results

Of the 25 patients, 9 (36%) required percutaneous drainage for a median of 7 days (5–14 days) after insertion, and 3 (12%) required conversion to reduced-port laparoscopic surgery with a 5-mm port insertion because of severe adhesions to adjacent organs. Of 22 patients undergoing SPLS, 13 underwent pure SPLS (52.0%) whereas 9 patients underwent SPLS with a 2-mm needle instrument (36.0%). Median operation time was 70 minutes (30–155 minutes), and a drainage tube was placed in 9 patients (36.0%). Median total length of incision was 2.5 cm (2.0–3.0 cm), and median time to soft diet initiation and length of stay in the hospital were 2 days (0–5 days) and 3 days (1–7 days), respectively. Two patients (8.0%) developed postoperative complications: 1 wound site bleeding and 1 surgical site infection.

Conclusion

Conservative management followed by a single-port laparoscopic interval appendectomy using a multichannel single-port appears feasible and safe for treating patients with acute perforated appendicitis with periappendiceal abscess.

Citations

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Single-port vs multi-port laparoscopic appendectomy in acute appendicitis: a systematic review
En Qing Lim, Aaron Jun Ket Lim, Adil Lakha, Zeeshan Razzaq
Langenbeck's Archives of Surgery.2025;[Epub] CrossRef
Comparison between liquid skin adhesive and wound closure strip for skin closure after subcuticular suturing in single-port laparoscopic appendectomy: a single-center retrospective study in Korea
Kyeong Eui Kim, Yu Ra Jeon, Sung Uk Bae, Woon Kyung Jeong, Seong Kyu Baek
Journal of Minimally Invasive Surgery.2024; 27(1): 14. CrossRef
Single-port laparoscopic appendectomy for perforated appendicitis using ArtiSential® wristed articulated instrument
Sung Uk Bae, Woon Kyung Jeong, Seong Kyu Baek
Journal of Minimal Access Surgery.2023; 19(1): 168. CrossRef
Single incision laparoscopic appendectomy with surgical-glove port is cost-effective and reliable in complicated acute appendicitis: A casecontrol multicenter study in Colombia
Andrés Felipe Carrillo Montenegro, Sofía Aristizabal Rojas, Jean André Pulido Segura, Mauricio Pedraza, Laura Padilla, Ivan David Lozada-Martinez, Alexis Rafael Narvaez-Rojas, Luis Felipe Cabrera-Vargas
Heliyon.2023; 9(1): e12972. CrossRef
A prospective randomized controlled study comparing patient-reported scar evaluation of single-port versus multiport laparoscopic appendectomy for acute appendicitis
Kyeong Eui Kim, In Soo Cho, Sung Uk Bae, Woon Kyung Jeong, Hyung Jin Kim, Seong Kyu Baek
Journal of Minimally Invasive Surgery.2023; 26(2): 55. CrossRef
Actinomycosis of the Appendix Mimicking Cecal Tumor Treated by Single-Port Laparoscopic Approach
In Soo Cho, Sung Uk Bae, Hye Ra Jung, Kyung Sik Park, Woon Kyung Jeong, Seong Kyu Baek
Annals of Coloproctology.2021; 37(2): 125. CrossRef
Single-incision Laparoscopy-assisted Appendectomy in the Pediatric Age Group: Our Experience
Hemanshi Shah, Charu Tiwari, Suraj Gandhi, Gursev Sandlas, Neha Sisodiya Shenoy
World Journal of Laparoscopic Surgery with DVD.2020; 13(2): 77. CrossRef
Clinical outcomes of single‐site laparoscopic interval appendectomy for severe complicated appendicitis: Comparison to conventional emergency appendectomy
Masaaki Miyo, Shoichiro Urabe, Satoshi Hyuga, Tomo Nakagawa, Toshiya Michiura, Nobuyasu Hayashi, Kazuo Yamabe
Annals of Gastroenterological Surgery.2019; 3(5): 561. CrossRef
Minimally Invasive Interval Appendectomy for Perforated Appendicitis With a Periappendiceal Abscess
Ik Yong Kim
Annals of Coloproctology.2016; 32(3): 88. CrossRef

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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30 Citations

Abstract PDF

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

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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
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Veli Avci, Kemal Ayengin, Zubeyir Huyut, Mehmet Tahir Huyut, Lokman Soysal, Salim Bilici
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Outcomes of a Single-Port Laparoscopic Appendectomy Using a Glove Port With a Percutaneous Organ-Holding Device and Commercially-Available Multichannel Single-Port Device: Jieun Lee, Sung Ryol Lee, Hyung Ook Kim, Byung Ho Son, Wonjun Choi; Ann Coloproctol. 2014;30(1):42-46. Published online February 28, 2014; DOI: https://doi.org/10.3393/ac.2014.30.1.42

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Abstract PDF

Purpose

A laparoscopic appendectomy is now commonly performed. The push in recent years toward reducing the number of ports required to perform this surgery has led to the development of a single-port laparoscopic appendectomy (SPA). We compared postoperative pain after an SPA using a glove port with a percutaneous organ-holding device (group 1) with that of an SPA using a commercially-available multichannel single-port device (group 2).

Methods

Between March 2010 and July 2011, a retrospective study was conducted of a total of 77 patients who underwent an SPA by three surgeons at department of surgery, Kangbuk Samsung Medical Center. Thirty-eight patients received an SPA using a glove port with a percutaneous organ-holding device. The other 39 patients received an SPA using a commercially-available multichannel single port (Octo-Port or SILS Port). Operative details and postoperative outcomes were collected and evaluated.

Results

There were no differences in the mean operative times, times to pass gas, postoperative hospital stays, or cosmetic satisfaction scores between the two groups. The pain score in the first 24 hours after surgery was higher in group 2 than group 1 patients (P < 0.001). Furthermore, the trocar used in group 2 was more expensive than that used in group 1.

Conclusion

An SPA using a glove port with a percutaneous organ-holding device was associated with a lower pain score during the first 24 hours after surgery because of the shorter fascia incision length and a cheaper cost than an SPA using a commercially-available multichannel single-port device.

Citations

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Single port surgery in pediatric age: report of first 300 cases
Nicola ZAMPIERI, Elettra VESTRI, Federica BIANCHI, Marta PERETTI, Simone PATANÈ, Mariangela CECCHETTO, Alberto MANTOVANI, Annamaria GIAMBANCO, Fabiana FARINA, Gabriella SCIRÈ, Francesco S. CAMOGLIO
Minerva Surgery.2023;[Epub] CrossRef
A brief overview of single-port laparoscopic appendectomy as an optimal surgical procedure for patients with acute appendicitis: still a long way to go
Yang Chen, Zongqi Fan, Xiaoxin Zhang, Xinao Fu, Jushang Li, Jieqing Yuan, Shigang Guo
Journal of International Medical Research.2023;[Epub] CrossRef
Laparoscopic Appendectomy Using the Surgical-Glove Port Through an Umbilical Incision: A Single-Center Retrospective Study
Tran Que Son, Tran Hieu Hoc, Vu Duc Long, Tran Thanh Tung, Nguyen Minh Tuan, Bui Minh Hue, Nguyen Van Minh, Nguyen Toan Thang
Cureus.2022;[Epub] CrossRef
The use of expanding ports in laparo-endoscopic single-site surgery may cause more pain: a meta-analysis of randomized clinical trials
Jannie Dressler, Lars N. Jorgensen
Surgical Endoscopy.2017; 31(11): 4400. CrossRef
Two-port laparoscopic anterior resection through a self-made glove device versus conventional laparoscopic anterior resection for rectal cancer: a comparison of short-term surgical results
Hong Zhang, Yunzhi Ling, Jinchun Cong, Mingming Cui, Dingsheng Liu, Chunsheng Chen
World Journal of Surgical Oncology.2016;[Epub] CrossRef
The learning curve of single-port laparoscopic appendectomy performed by emergent operation
YongHun Kim, WooSurng Lee
World Journal of Emergency Surgery.2016;[Epub] CrossRef
Needlescopic-Assisted Surgery: Single-Incision or Multi-Incision Laparoscopic Surgery?
Chang-Nam Kim
Annals of Coloproctology.2014; 30(1): 9. CrossRef

Postoperative Pain Relief Using Wound Infiltration With 0.5% Bupivacaine in Single-Incision Laparoscopic Surgery for an Appendectomy: So Ra Ahn, Dong Baek Kang, Cheol Lee, Won Cheol Park, Jeong Kyun Lee; Ann Coloproctol. 2013;29(6):238-242. Published online December 31, 2013; DOI: https://doi.org/10.3393/ac.2013.29.6.238

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Abstract PDF

Purpose

Recently, single-incision laparoscopic surgery (SILS) has been popular for minimally invasive surgery and cosmetic improvement. However, some papers have reported that SILS for an appendectomy (SILS-A) has had the more postoperative complaints of pain. We investigated postoperative pain relief using wound infiltration with 0.5% bupivacaine in SILS-A and compared the result with that for conventional SILS-A.

Methods

Between July 2010 and September 2012, 75 patients who underwent SILS-A were enrolled in this study. The patients were randomly assigned to two groups: conventional SILS-A group (C-SILS-A) or wound infiltrated with 0.5% bupivacaine in SILS-A group (W-SILS-A). Forty-five patients were in the C-SILS-A, and 30 patients were in the W-SILS-A. Patients with perforated appendicitis were excluded. The clinical outcomes were compared between the groups by using the verbal numerical rating scale (VNRS).

Results

Clinical outcomes were similar in both study groups except for the pain score. The W-SILS-A group showed significantly lower numbers of additional pain killers and lower VNRS scores 1, 6, and 12 hours after surgery than the C-SILS-A group.

Conclusion

W-SILS-A is a technically simple and effective method of reducing early postoperative pain. It may be applicable in SILS-A for pain control system.

Citations

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Single-Shot Subcutaneous Lidocaine Infiltration at Closure Is Associated with Reduced Early Pain and Opioid Requirement After Single-Incision Laparoscopic Totally Extraperitoneal Hernia Repair
Jong Min Lee
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V.V. Bedin, V.Yu. Vengerov, O.V. Makarov, N.I. Koroleva, K.A. Loginov, V.L. Polianskii, F.G. Pilyus
Pirogov Russian Journal of Surgery.2024; (12): 13. CrossRef
Clinical Outcomes of Single-incision Laparoscopic Appendectomy Versus Conventional Laparoscopic Appendectomy in Adult Acute Appendicitis
SHINTARO KOHAMA, KUNIHIKO NAGAKARI, MASAKAZU OHUCHI, KAZUHIRO TAKEHARA, KUMPEI HONJO, SHUN ISHIYAMA, KIICHI SUGIMOTO, SHINICHI OKA, JIRO YOSHIMOTO, MASAKI FUKUNAGA, YOICHI ISHIZAKI, KAZUHIRO SAKAMOTO
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Updates on Wound Infiltration Use for Postoperative Pain Management: A Narrative Review
Dusica M. Stamenkovic, Mihailo Bezmarevic, Suzana Bojic, Dragana Unic-Stojanovic, Dejan Stojkovic, Damjan Z. Slavkovic, Vladimir Bancevic, Nebojsa Maric, Menelaos Karanikolas
Journal of Clinical Medicine.2021; 10(20): 4659. CrossRef
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Vijayalakshmi Sivapurapu, SriVengadesh Gopal, Ashley Solomon
Journal of Anaesthesiology Clinical Pharmacology.2021; 37(3): 475. CrossRef
Effect of bupivacaine on postoperative pain and analgesics use after single-incision laparoscopic appendectomy: double-blind randomized study
Heon-Kyun Ha, Kyung-Goo Lee, Kang Kook Choi, Wan Sung Kim, Hyung Rae Cho
Annals of Surgical Treatment and Research.2020; 98(2): 96. CrossRef
Unilateral transversus abdominis plane block and port-site infiltration
Emine Arık, T. Akkaya, S. Ozciftci, A. Alptekin, Ş. Balas
Der Anaesthesist.2020; 69(4): 270. CrossRef
Effect of Local Anesthesia on the Postoperative Pain After Laparoscopic Appendectomy
Samir Čustovic, Haris Pandža, Samir Delibegovic
Journal of Laparoendoscopic & Advanced Surgical Techniques.2019; 29(1): 65. CrossRef
Diagnosis and management of acute appendicitis. EAES consensus development conference 2015
Ramon R. Gorter, Hasan H. Eker, Marguerite A. W. Gorter-Stam, Gabor S. A. Abis, Amish Acharya, Marjolein Ankersmit, Stavros A. Antoniou, Simone Arolfo, Benjamin Babic, Luigi Boni, Marlieke Bruntink, Dieuwertje A. van Dam, Barbara Defoort, Charlotte L. Dei
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Mun Gyu Kim, Soon Im Kim, Si Young Ok, Sang Ho Kim, Se-Jin Lee, Sun Young Park, Jae-Hwa Yoo, Ana Cho, Kyung Yul Hur, Myung Jin Kim
Korean Journal of Anesthesiology.2014; 67(6): 398. CrossRef
Preemptive Analgesia in Single-Incision Laparoscopic Surgery
Eui Gon Youk
Annals of Coloproctology.2013; 29(6): 221. CrossRef

Comparative Study of a Single-Incision Laparoscopic and a Conventional Laparoscopic Appendectomy for the Treatment of Acute Appendicitis: Jungwoo Kang, Byung Noe Bae, Geumhee Gwak, Inseok Park, Hyunjin Cho, Keunho Yang, Ki Whan Kim, Sehwan Han, Hong-Joo Kim, Young-Duck Kim; J Korean Soc Coloproctol. 2012;28(6):304-308. Published online December 31, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.6.304

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Abstract PDF

Purpose

For the treatment of acute appendicitis, a conventional laparoscopic appendectomy (LA) has been widely performed. Recently, the use of single incision laparoscopic surgery (SILS) is increasing because it is believed to have advantages over conventional laparoscopic surgery. In this study, we compared SILS and a conventional LA.

Methods

We analyzed the 217 patients who received laparoscopy-assisted appendectomies between August 2010 and April 2012 at Inje University Sanggye Paik Hospital. One hundred-twelve patients underwent SILS, and 105 patients underwent LA. For the two groups, we compared the operation times, postoperative laboratory results, postoperative pain, hospital stay, and postoperative complications.

Results

The patients' demographics, including body mass index, were not significantly different between the two groups. There were 6 perforated appendicitis cases in the SILS group and 5 cases in the LA group. The mean operative time in the SILS group was 65.88 ± 22.74 minutes whereas that in the LA group was 61.70 ± 22.27 minutes (P = 0.276). There were no significant differences in the mean hospital stays, use of nonsteroidal antiinflammatory drugs, and wound infections between the two groups.

Conclusion

Postoperative pain, complications and hospital stay showed no statistically significant differences between the SILS and the LA groups. However, our SILS method uses a single trocar and two latex tubes, so cost savings and reduced interference during surgery are expected.

Citations

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Sarah Assali, Sarah Eapen, Terry Carman, Sophia Horattas, Christopher R. Daigle, Charudutt Paranjape
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques.2018; 28(5): 291. CrossRef
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Sho Hirabayashi, Kenji Hibi, Yoshihiro Hotta, Ryohei Fukumoto, Takuya Watanabe, Junichi Sakamoto, Yasuhiro Kodera
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Gasless transumbilical laparoscopic-assisted appendectomy as a safe and cost-effective alternative surgical procedure for mild acute appendicitis
Koji Munakata, Mamoru Uemura, Junzo Shimizu, Masakazu Miyake, Taishi Hata, Kimimasa Ikeda, Keizo Dono, Masashi Kitada, Yuichiro Doki, Masaki Mori
Surgery Today.2016; 46(3): 319. CrossRef
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Alessandra C. Gasior, E. Marty Knott, George W. Holcomb, Daniel J. Ostlie, Shawn D. St. Peter
Journal of Pediatric Surgery.2014; 49(1): 120. CrossRef
Systematic Review and Meta‐Analysis of Randomized Controlled Trials Comparing Single Incision versus Conventional Laparoscopic Appendectomy
Michael Clerveus, Antonio Morandeira‐Rivas, Carlos Moreno‐Sanz, Maria Luz Herrero‐Bogajo, Joaquin Salvelio Picazo‐Yeste, Gloria Tadeo‐Ruiz
World Journal of Surgery.2014; 38(8): 1937. CrossRef
Single-Incision Laparoscopic Appendectomy
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Hyperbilirubinemia Is a Significant Indicator for the Severity of Acute Appendicitis: Young Ran Hong, Chul-Woon Chung, Jong Woo Kim, Chang Il Kwon, Dae Ho Ahn, Sung Won Kwon, Seong Ki Kim; J Korean Soc Coloproctol. 2012;28(5):247-252. Published online October 31, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.5.247

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27 Citations

Abstract PDF

Purpose

This study aims to reveal more effective clinical or laboratory markers for the diagnosis of acute appendicitis and to score the severity based on a sufficiently large number of patients with acute appendicitis.

Methods

We identified 1,195 patients with acute appendicitis after excluding those with other causes of hyperbilirubinemia among the 1,271 patients that underwent a laparoscopic or an open appendectomy between 2009 and 2010. A retrospective chart review of the medical records, including laboratory and histologic results, was conducted. We then analyzed the data using univariate and multivariate analyses.

Results

Among the 1,195 patients, a laparoscopic appendectomy was performed in 685 cases (57.32%), and an open appendectomy was performed in 510 cases (42.68%). The univariate analysis demonstrated significant differences for white blood cell count (P < 0.0001), segmented neutrophils (P = 0.0035), total bilirubin (P < 0.0001), and systemic inflammatory response syndrome (SIRS) score between groups (P < 0.0001). The multivariate analysis demonstrated that total bilirubin (odds ratio, 1.772; 95% confidence interval, 1.320 to 2.379; P = 0.0001) and SIRS score (odds ratio, 1.583; 95% confidence interval, 1.313 to 1.908; P < 0.0001) have statistically significant diagnostic value for perforated appendicitis.

Conclusion

Hyperbilirubinemia is a statistically significant diagnostic marker for acute appendicitis and the likelihood of perforation.

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A Clinical Comparison of Laparoscopic versus Open Appendectomy for Complicated Appendicitis: Sun Gu Lim, Eun Jung Ahn, Seong Yup Kim, Il Yong Chung, Jong-Min Park, Sei Hyeog Park, Kyoung Woo Choi; J Korean Soc Coloproctol. 2011;27(6):293-297. Published online December 31, 2011; DOI: https://doi.org/10.3393/jksc.2011.27.6.293

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Abstract PDF

Purpose

Although laparoscopic appendectomies (LAs) are performed universally, a controversy still exists whether the LA is an appropriate surgical approach to complicated appendicitis (CA). We retrospectively evaluated the outcomes of laparoscopic versus open appendectomies for CA.

Methods

We retrospectively analyzed 60 consecutive patients who were diagnosed as having CA from July 2009 to January 2011. Outcomes such as operative time, time to soft diet, length of hospital stay, and postoperative complications were analyzed.

Results

There were no statistically significant differences in operative time between the LA and the open appendectomy (OA) groups. Return to soft diet was faster in the LA group (2.1 ± 1.2 vs. 3.5 ± 1.5 days; P = 0.001). Length of hospital stay was shorter for the LA group (4.4 ± 2.3 vs. 5.8 ± 2.9 days; P = 0.045). The overall complication rates showed no statistically significant difference between the two groups. In cases involving a periappendiceal abscess, the LA had a significantly higher incidence of intra-abdominal abscess (IAA) and postoperative ileus (PI; P = 0.028).

Conclusion

The LA showed good results in terms of the time to soft diet, the length of hospital stay, and surgical site infection (SSI) whereas the overall complication rates were similar for the two groups. However, the LA was associated with significantly higher incidence of IAA and PI for the cases with a periappendiceal abscess. Therefore, when using a LA, the surgeon must take great care to minimize the incidence of IAA and PI if a periappendiceal abscess is present.

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Laparoscopic Versus Open Appendectomy for Appendicitis in Elderly Patients: Hyun Nam Baek, Yong Hwan Jung, Yong Hee Hwang; J Korean Soc Coloproctol. 2011;27(5):241-245. Published online October 31, 2011; DOI: https://doi.org/10.3393/jksc.2011.27.5.241

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Abstract PDF

Purpose

The appendectomy is the most common emergent surgical procedure in elderly patients. The increasing number of elderly persons has been accompanied by an increase in the number of cases of acute appendicitis in the elderly. In order to understand the clinical significance of a laparoscopic appendectomy for elderly patients with appendicitis, we investigated the results of a laparoscopic appendectomy for treating patients over 60 years of age with appendicitis and compared them with the results for an open technique.

Methods

We studied retrospectively patients over 60 years of age who underwent an appendectomy with either a laparoscopic (LA) or open (OA) technique for appendicitis between July 2007 and December 2009. There were 30 patients in the LA group and 47 patients in the OA group. The demographic data, operative time, length of the hospital stay, bowel movement, pain control, cost, complications and pre-existing disease were assessed.

Results

There were no significant differences between the LA and the OA groups with respect to pre-existing diseases, gender, age, American Society of Anesthesiologists (ASA) score and the number of cases of complicated appendicitis, operative time, length of hospital stay, and times of analgesics use. However, the proportion of early gas out (within POD #2) was significantly greater in the LA group (80% vs. 57%, P < 0.05), and postoperative complications were significantly lower in the LA group (7% vs. 32%, P < 0.01). The costs for the two groups were not significantly different.

Conclusion

A laparoscopic appendectomy is a safe and effective procedure in elderly patients and is not associated with any increase in morbidity. It can be recommended for routine use in treating elderly patients with appendicitis.

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Case Report

Transvaginal Endoscopic Appendectomy: Eung Jin Shin, Gui Ae Jeong, Jun Chul Jung, Gyu Seok Cho, Chul Wan Lim, Hyung Chul Kim, Ok Pyung Song; J Korean Soc Coloproctol. 2010;26(6):429-432. Published online December 31, 2010; DOI: https://doi.org/10.3393/jksc.2010.26.6.429

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Abstract PDF

Since Kalloo and colleagues first reported the feasibility and safety of a peroral transgastric approach in the porcine model in 2004, various groups have reported more complex natural orifice transluminal endoscopic surgery (NOTES) procedures, such as the cholecystectomy, splenectomy and liver biopsy, in the porcine model. Natural orifice access to the abdominal cavity, such as transgastric, transvesical, transcolonic, and transvaginal, has been described. Although a novel, minimally invasive approach to the abdominal cavity is a peroral endoscopic transgastric approach, there are still some challenging issues, such as the risk of infection and leakage, and the method of gastric closure. Hybrid-NOTES is an ideal first step in humans. Human hybrid transvaginal access has been used for years by many surgeons for diagnostic and therapeutic purposes. Here, we report a transvaginal flexible endoscopic appendectomy, with a 5-mm umbilical port using ultrasonic scissors in a 74-year-old woman with acute appendicitis.

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Original Article

Learning Curve for a Laparoscopic Appendectomy by a Surgical Trainee: Song Yi Kim, Sung Gun Hong, Hye Rin Roh, Seong Bae Park, Yang Hee Kim, Gi Bong Chae; J Korean Soc Coloproctol. 2010;26(5):324-328. Published online October 31, 2010; DOI: https://doi.org/10.3393/jksc.2010.26.5.324

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Abstract PDF

Purpose

The laparoscopic appendectomy has been a basic part of the principal of a more complex laparoscopic technique for the surgical trainee. As the number of laparoscopic appendectomies performed by surgical trainees has increased, we are trying to check the stability of, which is controversial, and the learning curve associated with a laparoscopic appendectomy.

Methods

We studied the demographics, histologic diagnoses, operative time, the number of complicated cases, and hospital duration of one hundred and three patients who underwent an open appendectomy (group A, 53) or a laparoscopic appendectomy (group B, 50) retrospectively through a review of their medical records. The learning curve for the laparoscopic appendectomy was established through the moving average and ANOVA methods.

Results

There were no differences in the operative times (A, 64.15 ± 29.88 minutes; B, 58.2 ± 20.72 minutes; P-value, 0.225) and complications (A, 11%; B, 6%; P-value, 0.34) between group A and group B. Group B was divided into group C who underwent the operation in the early period (before the learning curve) and group D who underwent the operation in the later period (after the learning curve). The average operative time for group C was 66.83 ± 21.55 minutes, but it was 45.25 ± 10.19 minutes for group D (P-value < 0.0001). Although this difference was statistically significant, no significant difference in the complication rate was observed between the two groups.

Conclusion

A laparoscopic appendectomy, compared with an open appendectomy, performed by a surgical trainee is safe. In this study, the learning curve for a laparoscopic appendectomy was thirty cases.

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Case Report

Laparoscopic Approach to a Case of Appendicular Schwannoma: Suk Won Suh, Joong Min Park, Yoo Shin Choi, Sung Jae Cha, In Taik Chang, Beom Gyu Kim; J Korean Soc Coloproctol. 2010;26(4):302-306. Published online August 31, 2010; DOI: https://doi.org/10.3393/jksc.2010.26.4.302

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Abstract PDF

Appendicular schwannoma is a rare tumor originating from Schwann's cells in the Auerbach plexus. The preoperative diagnosis is difficult because the clinical features are nonspecific, and it is mostly found accidentally via a radiologic image as a tumor, mimicking malignancy. We report a case of an appendicular schwannoma coexisting with an adenocarcinoma in the lung. A laparoscopic appendectomy was done with a clear resection margin, and the immunohistochemical staining showed positive S-100 protein, which confirmed the schwannoma. The patient also underwent a left upper lobectomy of the lung. The patient has been free of recurrence for the 6 months since the operation. The laparoscopic approach could be available for treatment of an appendicular schwannoma, thus avoiding an unnecessary laparotomy.

Citations

Citations to this article as recorded by

Appendiceal schwannoma — report of a case and literature review
Joseph P. Doyle, Ricky H. Bhogal, Monica Terlizzo, Vasileios K. Mavroeidis
Irish Journal of Medical Science (1971 -).2023; 192(4): 1801. CrossRef
Appendiceal schwannoma presenting as acute appendicitis
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Perilesional Lymph Node Swelling Might be a Radiologic Clue for Appendiceal Schwannoma: A Case Report
Kunihito Suzuki, Kazuhiro Saito, Takafumi Yamada, Elly Arizono, Hidehiro Kumita, Kenta Kasahara, Kenji Katsumata, Koichiro Tasaki, Jun Matsubayashi, Toshitaka Nagao
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Appendiceal schwannoma: an incidental finding after Crohn's bowel resection
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Schwannoma of the appendix: A case report and review of the literature
Ernest Cheng, Raymond Oliphant, Caroline Fung, Matthew Rickard, Anil Keshava
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Abdullah Mohammed Alshamrani, Rami Abdulrahman Sairafi, Ali Mohammed Alzahrani, Mostafa Abdel-Raheem
Journal of Surgical Case Reports.2018;[Epub] CrossRef
Laparoscopic Resection of Appendiceal Schwannoma
Toru Imagami, Satoru Takayama, Yohei Maeda, Ryohei Matsui, Masaki Sakamoto, Hisanori Kani
Case Reports in Surgery.2018; 2018: 1. CrossRef
A Case of Appendiceal Schwannoma
Kojiro OMIYA, Satoaki KAMIYA, Satoru KAWAI, Kenji TAKAGI, Masanori UNO, Akihiro TOMIDA
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Appendicular Schwannoma Presenting as Acute Appendicitis
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Acta Chirurgica Belgica.2015; 115(4): 317. CrossRef
A Case of Appendiceal Schwannoma
Jae Won Choi, Seung Keun Park
Intestinal Research.2013; 11(3): 223. CrossRef
Schwannoma of ascending colon treated by laparoscopic right hemicolectomy
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Original Articles

Laparoscopic Appendectomy with a Single Incision in a Single Institute: Jin A Lee, Ki Young Sung, Jun Hyun Lee, Do Sang Lee; J Korean Soc Coloproctol. 2010;26(4):260-264. Published online August 31, 2010; DOI: https://doi.org/10.3393/jksc.2010.26.4.260

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Abstract PDF

Purpose

The laparoscopic appendectomy has become popular for the treatment of acute appendicitis. A single-incision laparoscopic appendectomy offers better cosmesis. We present the results of single-incision laparoscopic appendectomies in our hospital as initial experience.

Methods

A single-incision laparoscopic appendectomy was performed in 75 patients at The Catholic University of Korea, Bucheon St. Mary's hospital. The operating time, operation type, hospital stay, surgical morbidities, and body mass index were compared.

Results

This retrospective study revealed equal operation times in both the suppurative and the perforated appendicitis group. There was an increase in the hospital stay in the perforated appendicitis group. The postoperative complication rate was 4%, and the median operation time was 58.55 ± 31.79 minutes.

Conclusion

The single-incision laparoscopic appendectomy was easy and safe procedure for treating acute appendicitis. There were no differences in degree of inflammation and body mass index.

Citations

Citations to this article as recorded by

Single-incision versus conventional multi-incision laparoscopic appendicectomy for suspected uncomplicated appendicitis
Ahmer Irfan, Ahsan Rao, Irfan Ahmed
Cochrane Database of Systematic Reviews.2025;[Epub] CrossRef
Single-incision versus conventional multi-incision laparoscopic appendicectomy for suspected uncomplicated appendicitis
Ahmer Irfan, Ahsan Rao, Irfan Ahmed
Cochrane Database of Systematic Reviews.2024;[Epub] CrossRef
A Comparative Study Between Single-Incision Laparoscopic Appendicectomy Using Conventional Instruments and Glove-Port (SILACIG) and Conventional Multiport Laparoscopic Appendicectomy (CMLA)
Ahamed Muneef, Uday Kumbhar, Chellappa Vijayakumar, Oseen Shaikh
Cureus.2020;[Epub] CrossRef
Feasibility of Single Port Laparoscopic Surgery in Patients with Perforated Appendicitis
Byung Seo Choi, Geon Young Byun, Seong Bae Hwang, Sung Ryul Lee
The Journal of Minimally Invasive Surgery.2016; 19(1): 19. CrossRef
A COMPARATIVE STUDY BETWEEN SINGLE INCISION MULTIPORT LAPAROSCOPIC APPENDICECTOMY AND CONVENTIONAL LAPAROSCOPIC APPENDECTOMY
Karunamoorthy Rajachidambaram, Dhinakaran Kaarthesan
Journal of Evolution of Medical and Dental Sciences.2016; 5(39): 2372. CrossRef
The Twin Forceps: A New Instrument for SILS
Antonia Rizzuto, Mario Donnici, Paola Nudo, Basilio Sinopoli, Rosario Sacco, Guido Danieli
BioMed Research International.2015; 2015: 1. CrossRef
Estudio comparativo prospectivo aleatorizado entre apendicectomía laparoscópica por puerto único y apendicectomía laparoscópica convencional
Rafael Villalobos Mori, Jordi Escoll Rufino, Fernando Herrerías González, M.Carmen Mias Carballal, Alfredo Escartin Arias, Jorge Juan Olsina Kissler
Cirugía Española.2014; 92(7): 472. CrossRef
Prospective, Randomized Comparative Study Between Single-port Laparoscopic Appendectomy and Conventional Laparoscopic Appendectomy
Rafael Villalobos Mori, Jordi Escoll Rufino, Fernando Herrerías González, M. Carmen Mias Carballal, Alfredo Escartin Arias, Jorge Juan Olsina Kissler
Cirugía Española (English Edition).2014; 92(7): 472. CrossRef
Surgical Outcomes of Single-port Laparoscopic Appendectomy versus Conventional Laparoscopic Appendectomy in Children: Preliminary Report of a Prospective Randomized Trial
Jung Rae Cho, Won Me Kang, Soo Min Ahn
Journal of the Korean Association of Pediatric Surgeons.2014; 20(2): 48. CrossRef
Single-incision laparoscopic appendectomy versus traditional three-port laparoscopic appendectomy: an analysis of outcomes at a single institution
F. Paul Buckley, Hannah Vassaur, Sharon Monsivais, Daniel Jupiter, Rob Watson, John Eckford
Surgical Endoscopy.2014; 28(2): 626. CrossRef
Comparison between single-incision and conventional three-port laparoscopic appendectomy: a meta-analysis from eight RCTs
Jun Gao, Ping Li, Qingguo Li, Dong Tang, Dao-Rong Wang
International Journal of Colorectal Disease.2013; 28(10): 1319. CrossRef
Single-Port Laparoscopic Appendectomy Versus Conventional Laparoscopic Appendectomy
Won-Suk Lee, Sang Tae Choi, Jung Nam Lee, Keon Kug Kim, Yeon Ho Park, Woon Kee Lee, Jeong-Heum Baek, Tae-Hoon Lee
Annals of Surgery.2013; 257(2): 214. CrossRef
Comparative Study Between Single-Incision and Three-Port Laparoscopic Appendectomy: A Prospective Randomized Trial
Bong-Hyeon Kye, Junhyun Lee, Wook Kim, Dongjae Kim, Dosang Lee
Journal of Laparoendoscopic & Advanced Surgical Techniques.2013; 23(5): 431. CrossRef
Outcomes of Single-Incision Laparoscopic Appendectomy at a Single Center
Takahiro Watanabe, Hidetosi Wada, Masanori Sato, Yuichirou Miyaki, Junpei Tochikubo, Norihiko Shiiya
Surgical Science.2013; 04(10): 426. CrossRef
A Review of Minimally Invasive Single-Port/Incision Laparoscopic Appendectomy
Haroon Rehman, Tim Mathews, Irfan Ahmed
Journal of Laparoendoscopic & Advanced Surgical Techniques.2012; 22(7): 641. CrossRef
Single incision versus conventional multi-incision appendicectomy for suspected appendicitis
Haroon Rehman, Ahsan M Rao, Irfan Ahmed
Cochrane Database of Systematic Reviews.2011;[Epub] CrossRef
Single port laparoscopic appendectomy: are we pursuing real advantages?
Nereo Vettoretto, Vincenzo Mandalà
World Journal of Emergency Surgery.2011; 6(1): 25. CrossRef
Technical approaches to single port/incision laparoscopic appendicectomy: a literature review
H Rehman, I Ahmed
The Annals of The Royal College of Surgeons of England.2011; 93(7): 508. CrossRef

Efficacy of a Laparoscopic Appendectomy When Performed by Surgeons Early in Their Laparoscopic Training Courses.: Joo, Kyu Hwa , Son, Byung Ho , Kim, Hyung Ook , Hwang, Sang Il , Kim, HungDai , Han, Won Kon; J Korean Soc Coloproctol. 2010;26(1):17-21.; DOI: https://doi.org/10.3393/jksc.2010.26.1.17

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Abstract PDF

PURPOSE
Laparoscopic surgery has many advantages and has been a popular method for the treatment of various diseases. Although a laparoscopic appendectomy (LA) is now a common practice, it has not yet become the treatment of choice for appendicitis of inexperienced surgeons in their early days of individual laparoscopic training courses. The purpose of this study was to compare the results obtained by inexperienced surgeons to those obtained by experienced surgeons.
METHODS
From May 2007 to January 2008, 130 patients underwent a LA at our department. The surgeries were performed by three surgeons. The patients were divided into 2 groups. In Group I, the LAs were performed by one surgeon who was experienced with laparoscopic procedures, and in Group II, the LAs were performed by two surgeons who were relatively inexperienced with laparoscopic procedures. We retrospectively reviewed patient's medical records for age, sex, previous abdomen operation history, operation method, operation time, surgical complications, length of hospital stay, and the time to resume soft diet.
RESULTS
The age was younger in Group I (29.8+/-18.2 vs. 36.0+/-16.0 yr, P=0.041). The operation time was longer in Group II (48.4+/-28.7 vs. 64.1+/-30.0 min, P=0.003). In Group I, wound infections developed in 4 cases. In Group II, wound infections developed in 7 cases, and an intraabdominal abscess developed in 1 case. The differences in conversion rates, times to start of diet, uses of analgesics, and hospital stays were not statistically significant.
CONCLUSION
Even though an inexperienced surgeon performs the LA for acute appendicitis, there are no differences in postoperative complications and returns to daily activities compared to a LA performed for acute appendicitis by an experienced surgeon. LA is a safe method for the treatment of acute appendicitis for surgeons who are new to laparoscopic procedures.

Citations

Citations to this article as recorded by

Learning curve in laparoscopic appendectomy: training strategy of laparoscopic surgery
Hyung Ook Kim
Annals of Coloproctology.2022; 38(3): 276. CrossRef
A Clinical Comparison of Laparoscopic versus Open Appendectomy for Complicated Appendicitis
Sun Gu Lim, Eun Jung Ahn, Seong Yup Kim, Il Yong Chung, Jong-Min Park, Sei Hyeog Park, Kyoung Woo Choi
Journal of the Korean Society of Coloproctology.2011; 27(6): 293. CrossRef

The Necessity of a Routine Interval Appendectomy Necessary in Adults?: Initial Experience.: Park, Jong Deok , Lee, Chang Ho , Kim, Jong Hun , Kim, Yong Kon , Lee, Min Ro; J Korean Soc Coloproctol. 2010;26(1):12-16.; DOI: https://doi.org/10.3393/jksc.2010.26.1.12

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Abstract PDF: PURPOSE
The traditional management of a periappendiceal abscess or a perforated appendicitis has been initial conservative treatment, followed by an interval appendectomy (IA). However, the necessity of the interval appendectomy has been questioned by an increasing number of studies recently. The purpose of this study was to clarify the role of conservative treatment, instead of IA, in managing a perforated appendicitis or a periappendiceal abscess after successful initial conservative treatment.
METHODS
We prospectively studied 26 out of 80 patients who had been admitted for a perforated appendicitis or a periappendiceal abscess to Chonbuk National University Hospital from March 2005 to December 2007. These 26 patients were initially treated by using conservative treatment instead of surgery. We analyzed these 26 patients' progression and prognosis after treatment. The IAs were conducted at intervals of 6 to 12 wk after colonoscopy when the patient wanted an operation.
RESULTS
Twenty-three out of 26 (88.5%, 23/26) patients were improved after initial conservative treatment. Only 3 patients who were not improved were managed surgically. Four out of 23 patients who were relieved by conservative treatment underwent an IA voluntarily at intervals of 6 to 12 wk. Of the remaining 19 patients without IA, 1 patient (5%, 1/19) suffered a recurrence after 6 mo, and an appendectomy was performed. Eighteen (78%, 18/23) patients without an IA have shown no recurrence for 15 mo, and they are still being followed up.
CONCLUSION
We conclude that a routine IA after successful initial conservative treatment for a perforated appendicitis or a periappendiceal abscess seems unnecessary. Those patients should undergo colonoscopy to detect any underlying diseases and to rule out coexistent colorectal cancer.

The Initial Experience with a Single Incision Laparoscopic Appendectomy.: Kim, Jong Won , Park, Jun Seok , Chang, In Taik , Choi, Yoo Shin , Song, Hyung Jun , Kim, Beom Gyu; J Korean Soc Coloproctol. 2009;25(5):312-317.; DOI: https://doi.org/10.3393/jksc.2009.25.5.312

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9 Citations

Abstract PDF

PURPOSE
A laparoscopic appendectomy (LA) is becoming popular for the treatment of acute and perforated appendicitis. Since it was first described, the LA has been modified many times. We present the result for a new technique of LA, in which the LA is conducted through a single umbilical incision without exteriorizing the appendix to perform the operation.
METHODS
A single incision laparoscopic appendectomy was attempted in 25 patients (17 men, 8 women). Under general anesthesia, a wound retractor was inserted through the umbilicus. The appendix was grasped and dissected from surrounding tissues with a single flexible dissector or grasper. After mesenteric dissection with ultrasonic shear, the base of the appendix was ligated with an Endoloop. The appendix was withdrawn into the wound protector and extracted from the abdomen.
RESULTS
A single incision laparoscopic appendectomy was completed in 25 patients. No major intraoperative or postoperative complications were encountered. The average duration of the procedure was 50.3+/-21.3 min. The average hospital stay was 4.1+/-2.4 days.
CONCLUSION
This new technique, a single incision laparoscopic appendectomy, further improves the minimal invasiveness of a LA because a single incision is used. This procedure is a safe, very minimally invasive procedure with excellent cosmetic results.

Citations

Citations to this article as recorded by

Single-incision versus conventional multi-incision laparoscopic appendicectomy for suspected uncomplicated appendicitis
Ahmer Irfan, Ahsan Rao, Irfan Ahmed
Cochrane Database of Systematic Reviews.2025;[Epub] CrossRef
Single-incision versus conventional multi-incision laparoscopic appendicectomy for suspected uncomplicated appendicitis
Ahmer Irfan, Ahsan Rao, Irfan Ahmed
Cochrane Database of Systematic Reviews.2024;[Epub] CrossRef
Comparative Study of a Single-Incision Laparoscopic and a Conventional Laparoscopic Appendectomy for the Treatment of Acute Appendicitis
Jungwoo Kang, Byung Noe Bae, Geumhee Gwak, Inseok Park, Hyunjin Cho, Keunho Yang, Ki Whan Kim, Sehwan Han, Hong-Joo Kim, Young-Duck Kim
Journal of the Korean Society of Coloproctology.2012; 28(6): 304. CrossRef
What Are the Risk Factors for Complication in Transumbilical Single-Port Appendectomy?
Hee Sung Lee, Yong Hae Baik, In Woong Han, Won Yong Choi, Beom Seok Kwak, Young Jin Park, Min Gu Oh, Hong Yong Kim
The Journal of Minimally Invasive Surgery.2012; 15(4): 138. CrossRef
A Review of Minimally Invasive Single-Port/Incision Laparoscopic Appendectomy
Haroon Rehman, Tim Mathews, Irfan Ahmed
Journal of Laparoendoscopic & Advanced Surgical Techniques.2012; 22(7): 641. CrossRef
Single-incision Appendectomy is Comparable to Conventional Laparoscopic Appendectomy
Richdeep S. Gill, Xinzhe Shi, David P. Al-Adra, Daniel W. Birch, Shahzeer Karmali
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques.2012; 22(4): 319. CrossRef
Single incision versus conventional multi-incision appendicectomy for suspected appendicitis
Haroon Rehman, Ahsan M Rao, Irfan Ahmed
Cochrane Database of Systematic Reviews.2011;[Epub] CrossRef
Technical approaches to single port/incision laparoscopic appendicectomy: a literature review
H Rehman, I Ahmed
The Annals of The Royal College of Surgeons of England.2011; 93(7): 508. CrossRef
Laparoscopic Appendectomy with a Single Incision in a Single Institute
Jin A Lee, Ki Young Sung, Jun Hyun Lee, Do Sang Lee
Journal of the Korean Society of Coloproctology.2010; 26(4): 260. CrossRef

A Case of Single Port Laparoscopic Appendectomy and Cholecystectomy in a Fresh Cadaver: A Feasible Procedure.: Kim, Hyung Jin , Lee, Jae Im , Lee, Yoon Suk , Kang, Won Kyung , Lee, Sang Kuon , You, Young Kyung , Oh, Seong Taek; J Korean Soc Coloproctol. 2009;25(1):59-62.; DOI: https://doi.org/10.3393/jksc.2009.25.1.59

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Abstract PDF

We performed single port transumbilical appendectomy and cholecystectomy using the TriPort (R-port, Advanced Surgical Concepts, Wicklow, Ireland), inserted through a transumbilical incision in a cadaver model. A articulating instrument, Autonomy(TM) (Cambridge Endo, MA, USA) in right hand was used for retraction in addition to a standard laparoscopic instrument in left hand for dissection and coagulation. Both procedures were technically successful. In conclusion, single port surgery may be performed safely. And in the near future, more complex procedures could be performed through single port in accordance with the advancement of the instruments.

Citations

Citations to this article as recorded by

Bending Mechanism Analysis and Bending Coupler Optimal Design for Laparoscopic Surgical Instrument
Dal Yeon Hwang, Dae Hoan Moon, Seung Wook Choi, Jong Seok Won
Journal of the Korean Society of Precision Engineering.2013; 30(4): 434. CrossRef
Single-port transumbilical laparoscopic appendectomy: 43 consecutive cases
Hyung Jin Kim, Jae Im Lee, Yoon Suk Lee, In Kyu Lee, Jung Hyun Park, Sang Kuon Lee, Won Kyung Kang, Hyeon-Min Cho, Young Kyuong You, Seong Taek Oh
Surgical Endoscopy.2010; 24(11): 2765. CrossRef
Single port laparoscopic surgery
Woo-Jung Lee
Journal of the Korean Medical Association.2010; 53(9): 793. CrossRef
Single-Port Laparoscopic Appendectomy
Hyung Jin Kim, Jae Im Lee, Sang Chul Lee, Soo Hong Kim, In Kyu Lee, Yoon Suk Lee, Hyeon-Min Cho, Seong Taek Oh
Journal of the Korean Surgical Society.2010; 78(5): 338. CrossRef

Clinical Evaluation of Laparoscopic Appendectomy.: Lee, Min Hwa , Song, Byung Joo , Choi, Sang Yong , Park, Sin Hee , Kim, Chin Seung; J Korean Soc Coloproctol. 1998;14(3):551-560.

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9 Download

Abstract PDF: BACKGROUND
This study was performed to evaluate our experience on laparoscopic appendectomy.
METHODS
Retrospective analysis was performed on 2,856 patients who had been operated by laparoscopic appendectomy under diagnosis of acute appendicitis at the Sung-Ae Hospital and Kwang-Myoung Sung-Ae Hospital from October 1991 to July 1998.
RESULTS
Among 2,856 patients who had undergone laparoscopic appendectomy,2,379 patients (83.3%) were operated due to simple acute appendicitis, 275 patients (9.6%) due to perforated appendicitis. Operation time was 44.6 minutes for simple acute appendicitis and 60.3 minutes for perforated appendicitis. In perforated appendicitis, intra-peritoneal irrigation and drain insertion was performed. The length of hospital stay in patient with simple acute appendicitis was 3.7 days (5.82 days in conventional appendectomy) and patients with perfotrated appendicitis was 6.1 days (9.91 days in conventional appen-dectomy). Complications such as wound infection, intra-abdomen abscess, trocar site bleeding, subcutaneous emphysema developed in 43 (1.5%) patients (79/1,947, 4.5% in conventional appendectomy). In 202 (7.1%) patients, appendix was normal, but another diseases were detected, including acute pelvic inflammation, ovarian cyst, mesenteric lymphadenitis, enteritis, diverticulitis in order.
CONCLUSION
Overall complication rate was lower in laparoscopic appendectomy compared with conventional appendectomy and the length of hospitalization of laparoscopic appendectomy was shorter. When the acute appendicitis is suspected, especially in the reproductive women, the laparoscopic approach would be better diagnostic and therapeutic value than conventional method. Therefore laparoscopic appendectomy would be replaced with conventional appendectomy.

Clinical Usefulness of Laparoscopic Appendectomy.: Shin, Jun Ho , Park, Yong Kai , Kim, Heung Dae; J Korean Soc Coloproctol. 1998;14(3):541-550.

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Abstract PDF: PURPOSE
There have been numerous retrospective and uncontrolled study of laparoscopic appendectomy. Although most of these have concluded that the laparoscopic appendectomy is at least as good as open appendectomy, there has been considerable controversy as to whether laparoscopic appendectomy is superior.
METHODS
We performed total 47 cases of laparoscopic appendectomy (LA) during one year from January 1997 to December 1997 and these were compared with 50 cases of open appendectomy (OA) in same period to assess the clinical usefulness.
RESULTS
The sex, male to female ratio and severity of appendicitis were similar in both groups. The anesthetic time was longer in the LA group (P<0.05) but operative time was similar. Gas-passing time and diet-intake time in postoperative period were earlier in LA group (P<0.05). The LA group required less analgesics in postoperative period. In LA group, no case was converted to open appendectomy and overall complication rate was lower in LA group but this was not statistically significant. Among the postoperative complication, the wound infection rate was absolutely lower in LA group (P<0.05). The diagnostic rate for acute abdomen including acute appendicitis was superior in LA group, especially in reproductive women. The hospital stay was shorter in LA group (P<0.05) and hospital charges was not different in both group.
CONCLUSION
Laparoscopic appendectomy offers considerable advantages over open appendectomy because this has ability to reduce postoperative complications and shorten recovery times and is useful for detecting the cause of acute abdomen other than acute appendicitis. So we expect this technique will be alternative operation or new standard operation in selected cases for suggestive acute appendicitis.

Case Report

Laparoscopic Appendectomy for Acute Appendicitis Caused by Enterobius Vermicularis.: Lee, Yoon suk , Lee, In kyu , Oh, Seung teak , Kim, Jun gi , Jang, Suk kyun , Kim, Young ha , Kim, Kyung Mee; J Korean Soc Coloproctol. 2005;21(4):255-257.

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Abstract PDF: Enterobius vermicularis (pinworm) infection occurs in 4~28% worldwide. Although the most common clinical manifestation is perianal pruritis, it may cause gastrointestinal manifestations, including acute appendicitis in about 0.2~41.8% of infections. Preoperative diagnosis of pinworms in patients with acute appendicitis is not routinely performed. We performed a laparoscopic appendectomy for an acute appendicitis caused by Enterobius vermicularis. To our knowledge, this is the first report of a laparoscopic appendectomy for acute appendicitis caused by Enterobius vermicularis in Korea.

Randomized Controlled Trial

Preventive Effects for Wound Infection of Intra-incisional Metronidazole Infiltration Preoperatively in Appendectomy.: Park, Bu Il , Kim, Byung Seok , Moon, Duk Jin , Park, Ju Sub; J Korean Soc Coloproctol. 2000;16(6):356-359.

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Abstract PDF: PURPOSE
The aim of this prospective study was to evaluate the effect of metronidazole for wound infection by using intra-incisional infiltration before appendectomy.
METHODS
From January to May 2000, 176 patients with acute appendicitis received appendectomy. All patients were randomly divided into two groups. Group I (n=50) was the treatment group and group II (n=126) was the control group. After anesthesizing the patients of group I, 7.5 mg/kg of metronidazole was injected into subcutaneous tissue and muscle. All patients of group I and II were given intravenous injection of cephalosporin and intravenous or intramuscular injection of aminoglycoside.
RESULTS
In the 50 cases of group I, the rate of wound infection was 2% and the rate of wound infection in the 126 cases of group II was 4.8%. The rate of anaerobic bacteria of organisms cultured from wound of patients with infection was 0% in group I and 33% in group II. The statistical analysis using chi-square test was not significant (p=0.676) but the rate of wound infection was reduced, especially in infection caused by anaerobic bacteria.
CONCLUSIONS
The rate of wound infection was not significant statistically but it was reduced after intra-incisional infiltration of metronidazole. Therefore we suggest that this method can be one of methods that reduce the rate of wound infection after appendectomy.

Original Articles

Clinical Analysis of Patients with Acute Appendicitis Operated on during.: Lee, Dong Il , Choi, Sung In , Moon, Jae hwan; J Korean Soc Coloproctol. 1999;15(5):376-385.

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Abstract PDF: PURPOSE
During the night time decision making on patients suspicious of appendicitis is often difficult because diagnosis and timing for operation are frequently delayed. Therefore, we analyzed above cases and solution is suggested.
METHODS
This retrospective study included 360 patients who underwent laparotomies for suspected appendicitis at Hanil Hospital during one year, from March 1998 to Feb. 1999. They were divided into two groups according to presenting time to physician (Day time: 6 a.m. to 6 p.m., Night time: 6 p.m. to 6 a.m.). Sex & age distribution, time of presentation to physician, duration of symptoms, symptoms & physical findings, white blood cell counts, interval from presentation to operation, hospital stay, and pathologic diagnosis were compared.
RESULTS
There were no significant differences in sex & age distribution, duration of symptoms, symptoms & physical findings, white blood cell counts, pathologic diagnosis between the two groups. However, during the night time, the interval from presentation to operation was longer than that of the day time (9.15 hours versus 4.83 hours, p<0.001), the rate of delayed appendectomy during the night was 58.0%, the rate of negative laparotomy increased when appendectomy was delayed for more than 12 hours compared with less than 12 hours (28.1% vs 11.7%, p<0.01), and in the cases with perforated appendicitis, delayed appendectomy for more than 12 hours had longer hospital stay compared with less than 12 hours (12 days vs 9.44 days, p<0.01). Factors causing delayed appendectomy were related to the physician (42.5%), lack of anesthetic & nursing supports (19.5%), failure to structure the operation team (20.7%), and patient itself (17.3%). When white blood cell counts were rechecked in the next morning, levels above 10,000 cells/mm3 were highly associated with appendicitis in contrast to that below 10,000 cells/mm3 (91.7% vs 43.5%, p<0.002).

Comparison between an Interval Appendectomy and an Urgent Appendectomy for Patients of Periappendiceal Abscess.: Cho, Sung Wook , Kim, In Gyu , Lee, Bong Hwa; J Korean Soc Coloproctol. 2003;19(5):276-281.

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Abstract PDF: PURPOSE
Our goal was to compare the clinical course after an interval appendectomy with that after an urgent appendectomy in patients with localized periappendiceal abscesses confirmed by radiology.
METHODS
This study was a retrospective review of 57 consecutive patients who were treated between February 1999 and June 2003 for appendicitis complicated by periappendiceal abscess. For periappendiceal abscesses, 37 patients were treated with an urgent appendectomy, but 20 patients were treated initially non-operatively. Finally, 12 of those 20 patients underwent an interval appendectomy. Exclusion criteria were periappendiceal abscesses spreading to the whole abdomen diffusely, as confirmed by either abdominal CT or ultrasonography.
RESULTS
Interval appendectomies were performed in 12 (60%) of the patients in the 20 initial non-operative group. The complication rate for the 12 patients in the initial non-operative group who underwent an interval appendectomy was significantly lower than that for the 37 patients in the urgent appendectomy group (P<0.05). The duration of nothing by mouth (NPO) and the length of the hospital stay in the initial non-operative group with an interval appendectomy were also significantly lower than those in the urgent appendectomy group (P<0.05). The histopathologic finding for the interval appendectomy group was suppurative appendicitis in 9 of the 12 cases.
CONCLUSIONS
Initial non-operative treatment with an interval appendectomy has been relatively fewer postoperative problems than an urgent appendectomy in patients with localized periappendiceal abscesses in our study, and further study in more large series considered to be needed.

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