Komplike Olmayan Apandisit Ön Tanılı Çocuklarda Cerrahi Olmayan Tedavinin Klinik Sonuçları

Year 2022, , 190 - 198, 31.08.2022

Şeref Selçuk Kılıç , Onder Ozden

https://doi.org/10.36516/jocass.1135069

Abstract

Amaç
Ameliyatsız tedavi yaklaşımı, apendiksteki enfeksiyonun baskılandığı ve antibiyotiklerle tedavi edildiği komplike olmayan apandisit tedavisinde kullanılan diğer bir yöntemdir. Çalışmamızın amaçları komplike olmayan apandisit ön tanılı çocuk hastalarda ameliyatsız tedavinin klinik sonuçlarının ve rekürrens gelişmesi için risk faktörlerinin araştırılmasıdır.
Yöntemler
Ocak 2016 ve Ocak 2021 tarihleri arasında üçüncü basamak bir çocuk cerrrahisi merkezinde komplike olmayan apandisit ön tanılı ve ameliyatsız tedavi uygulanmış hastaların tıbbi verileri değerlendirildi. Hastaların tanımlayıcı bilgileri, tedavi süreci ve klinik sonuçları kaydedildi. Ameliyatsız tedavi sonrası rekürrens gelişen ve gelişmeyen iki hasta grubunun verileri istatistiksel olarak karşılaştırıldı.
Bulgular
Ortanca yaşı 13 (6-17) yıl olan 41 hastanın verileri değerlendirildi. Sekiz (%19.5) hastada apendikolit vardı. Ortanca IV antibiyotik tedavi süresi 4 (3-7) gün ve hastaların ortanca abdominal hassasiyetlerinin kaybolma süresi 2 (1-4) gündü. Ameliyatsız tedaviden ortanca 7 (1-14) ay sonra 8 (%19.5) hastada rekürrens gelişti. Rekürrens gelişen grupta abdominal hassasiyetin kaybolma süresi diğer gruba göre istatistiksel anlamlı olarak daha uzundu (p=0.01).
Sonuç
Çalışmamız apendikolitin rekürrens gelişimi için risk faktörü oluşturmadığını ortaya koydu. Abdominal hassasiyetin kaybolması için geçen zaman rekürrens gelişimi için yüksek riskli hastaların tespitinde faydalı olabilir.

Keywords

apandisit, ameliyatsız tedavi, antibiyotik, çocuk

Clinical Outcomes of Non-Operative Treatment of Suspected Uncomplicated Appendicitis in Children

Abstract

Aim
Non-operative treatment approach is another method used in the treatment of uncomplicated appendicitis, in which the infection in the appendix is suppressed and treated with antibiotics. Our study aims to investigate the clinical outcomes and the risk factors for recurrence in our pediatric patients with suspected uncomplicated appendicitis, who underwent non-operative treatment.
Methods
The medical data of the patients who underwent non-operative treatment with the diagnosis of suspected uncomplicated appendicitis between January 2016 and January 2021 in a tertiary pediatric surgery center were analyzed. Demographic data, treatment process, and clinical results of the patients were recorded. Statistical evaluation was made by comparing the two groups with and without recurrence after non-operative treatment.
Results
The median age of 41 patients whose data were evaluated was 13 (6-17) years. Eight patients (19.5%) had appendicolith. The median duration of IV antibiotic treatment was 4 (3-7) days, and the patients' abdominal tenderness disappeared in a median of 2 (1-4) days. Recurrence developed in 8 (19.5%) patients after a median of 7 (1-14) months after non-operative treatment. It was found that the time to the disappearance of abdominal tenderness was statistically longer in the group that developed recurrence than that in the group that did not (p=0.01).
Conclusion
Our study revealed that appendicolith was not a risk factor for the development of recurrence. The time to the disappearance of abdominal tenderness may be useful for detecting patients at a higher risk of recurrence.

Keywords

appendicitis, non-operative treatment, antibiotic, children

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