Histopathological Analysis as Support for the Applicaibility of Interval Appendectmy: A Single-Center Retrospective Study

Ryosuke Kita; Daisuke Yamashita; Koji Kitamura; Masato Kondo; Hiroyuki Kobayashi; Kenji Uryuhara; Hiroki Hashida; Satoshi Kaihara

doi:doi:10.11648/j.js.20221002.11

Histopathological Analysis as Support for the Applicaibility of Interval Appendectmy: A Single-Center Retrospective Study

Ryosuke Kita, Daisuke Yamashita, Koji Kitamura, Masato Kondo, Hiroyuki Kobayashi, Kenji Uryuhara, Hiroki Hashida, Satoshi Kaihara

Published in Journal of Surgery (Volume 10, Issue 2)

Received: 6 February 2022 Accepted: 22 February 2022 Published: 3 March 2022

Views: Downloads:

Download PDF

Share This Article

Twitter
Linked In
Facebook

Abstract

Background: The management of perforated appendicitis with abscess, including interval appendectomy, remains controversial. Materials and Methods: The study was a retrospective analysis of patients diagnosed as having perforated appendicitis with abscess who were treated in our hospital between April 2014 and December 2020. A total of 51 patients who underwent successful interval appendectomy protocol were included. Residual pathological inflammation in the resection specimens and the relationship between preoperative computed tomography imaging and residual inflammation findings were evaluated. Results: All patients who had successful interval appendectomy received laparoscopic appendectomy as an elective surgery. Postoperative complications included superficial surgical site infection in two patients (4%). Pathological assessment of the resection specimens of interval appendectomy revealed acute inflammation and chronic inflammation in 11 patients (22%) and 25 patients (49%), respectively. Preoperative computed tomography imaging showed elevated peri-appendiceal fat tissue concentration and residual abscesses in 11 patients (22%) and five patients (10%), respectively. Residual inflammation was significantly higher in patients who had exhibited elevated peri-appendiceal fat tissue concentration on preoperative computed tomography imaging. Conclusions: Despite the absence of abdominal pain or other inflammatory symptoms, 70% patients showed pathological evidence of ongoing inflammation even after 3 months of conservative treatment. Given the high percentage of resection specimens showing acute or chronic appendicitis, interval appendectomy should be performed for complete elimination of inflammation.

Published in	Journal of Surgery (Volume 10, Issue 2)
DOI	10.11648/j.js.20221002.11
Page(s)	57-61
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2022. Published by Science Publishing Group

Keywords

Interval Appendectomy, Computed Tomography, Inflammation, Pathology

References

[1]	K. S. Perez, S. R. Allen, Complicated appendicitis and considerations for interval appendectomy, J. A. A. P. A. Off. J. Am. Acad. Phys. Assist. 31 (9) (2018) 35–41.
[2]	G. C. Garst, E. E. Moore, M. N. Banerjee, D. K. Leopold, C. C. Burlew, D. D. Bensard, W. L. Biffl, C. C. Barnett, J. L. Johnson, A. Sauaia, Acute appendicitis: a disease severity score for the acute care surgeon, J. Trauma Acute Care Surg. 74 (1) (2013) 32–36.
[3]	J. Z. Lugo, D. V. Avgerinos, A. J. Lefkowitz, M. E. Seigerman, I. S. Zahir, A. Y. Lo, B. Surick, I. M. Leitman, Can interval appendectomy be justified following conservative treatment of perforated acute appendicitis?, J. Surg. Res. 164 (1) (2010) 91–94.
[4]	K. S. You, D. H. Kim, H. Y. Yun, L. C. Jang, J. W. Choi, Y. J. Song, D. H. Ryu, The value of a laparoscopic interval appendectomy for treatment of a peri-appendiceal abscess: experience of a single medical center, Surg. Laparosc. Endosc. Percutan. Tech. 22 (2) (2012) 127–130.
[5]	R. Kita, H. Hashida, D. Yamashita, H. Kinoshita, M. Kondo, S. Kaihara, Usefulness and cost-effectiveness of interval appendectomy for complicated appendicitis, J. Surg. 9 (3) (2021) 109–113.
[6]	D. Puapong, S. L. Lee, P. I. Haigh, A. Kaminski, I. L. Liu, H. Applebaum, Routine interval appendectomy in children is not indicated, J. Pediatr. Surg. 42 (9) (2007) 1500–1503.
[7]	M. Rosen, A. Chalupka, K. Butler, A. Gupta, S. R. Odom, Pathologic findings suggest long-term abnormality after conservative management of complex acute appendicitis, Am. Surg. 81 (3) (2015) 297–299.
[8]	A. Al-Kurd, I. Mizrahi, Siam B, Kupietzky A, Hiller N, Beglaibter N, Eid A, Mazeh H: Outcomes of interval appendectomy in comparison with appendectomy for acute appendicitis. The Journal of surgical research 2018, 225: 90-94.
[9]	A. Korniluk, O. Koper, H. Kemona, V. Dymicka-Piekarska, From inflammation to cancer, Ir. J. Med. Sci. 186 (1) (2017) 57–62.
[10]	N. Eiró, F. J. Vizoso, Inflammation and cancer, World J. Gastrointest. Surg. 4 (3) (2012) 62–72.
[11]	M. L. Salem, Z. I. Attia, S. M. Galal, Acute inflammation induces immunomodulatory effects on myeloid cells associated with anti-tumor responses in a tumor mouse model, J. Adv. Res. 7 (2) (2016) 243–253.
[12]	F. R. Balkwill, A. Mantovani, Cancer-related inflammation: common themes and therapeutic opportunities, Semin. Cancer Biol. 22 (1) (2012) 33–40.
[13]	P. J. Willemsen, L. E. Hoorntje, E. H. Eddes, R. J. Ploeg, The need for interval appendectomy after resolution of an appendiceal mass questioned, Dig. Surg. 19 (3) (2002) 216–220.
[14]	G. P. Wright, M. E. Mater, J. T. Carroll, J. S. Choy, M. H. Chung, Is there truly an oncologic indication for interval appendectomy?, Am. J. Surg. 209 (3) (2015) 442–446.
[15]	M. Castelló González, J. C. Bueno Rodríguez, E. Hernández Moore, D. Aguilar Atanay, Predictors of recurrent appendicitis after non-operative management of children with perforated appendicitis presenting with an appendicular inflammatory mass, Arch. Dis. Child. 99 (2) (2014) 154–157.
[16]	H. M. Tsai, Y. S. Shan, P. W. Lin, X. Z. Lin, C. Y. Chen, Clinical analysis of the predictive factors for recurrent appendicitis after initial nonoperative treatment of perforated appendicitis, Am. J. Surg. 192 (3) (2006) 311–316.
[17]	J. Mällinen, T. Rautio, J. Grönroos, T. Rantanen, P. Nordström, H. Savolainen, P. Ohtonen, S. Hurme, P. Salminen, Risk of appendiceal neoplasm in peri-appendicular abscess in patients treated with interval appendectomy vs follow-up with, JAMA Surg. 154 (3) (2019) 200–207.

Cite This Article

Plain Text BibTeX RIS

APA Style

Ryosuke Kita, Daisuke Yamashita, Koji Kitamura, Masato Kondo, Hiroyuki Kobayashi, et al. (2022). Histopathological Analysis as Support for the Applicaibility of Interval Appendectmy: A Single-Center Retrospective Study. Journal of Surgery, 10(2), 57-61. https://doi.org/10.11648/j.js.20221002.11

Copy | Download

ACS Style

Ryosuke Kita; Daisuke Yamashita; Koji Kitamura; Masato Kondo; Hiroyuki Kobayashi, et al. Histopathological Analysis as Support for the Applicaibility of Interval Appendectmy: A Single-Center Retrospective Study. J. Surg. 2022, 10(2), 57-61. doi: 10.11648/j.js.20221002.11

Copy | Download

AMA Style

Ryosuke Kita, Daisuke Yamashita, Koji Kitamura, Masato Kondo, Hiroyuki Kobayashi, et al. Histopathological Analysis as Support for the Applicaibility of Interval Appendectmy: A Single-Center Retrospective Study. J Surg. 2022;10(2):57-61. doi: 10.11648/j.js.20221002.11

Copy | Download

@article{10.11648/j.js.20221002.11,
  author = {Ryosuke Kita and Daisuke Yamashita and Koji Kitamura and Masato Kondo and Hiroyuki Kobayashi and Kenji Uryuhara and Hiroki Hashida and Satoshi Kaihara},
  title = {Histopathological Analysis as Support for the Applicaibility of Interval Appendectmy: A Single-Center Retrospective Study},
  journal = {Journal of Surgery},
  volume = {10},
  number = {2},
  pages = {57-61},
  doi = {10.11648/j.js.20221002.11},
  url = {https://doi.org/10.11648/j.js.20221002.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20221002.11},
  abstract = {Background: The management of perforated appendicitis with abscess, including interval appendectomy, remains controversial. Materials and Methods: The study was a retrospective analysis of patients diagnosed as having perforated appendicitis with abscess who were treated in our hospital between April 2014 and December 2020. A total of 51 patients who underwent successful interval appendectomy protocol were included. Residual pathological inflammation in the resection specimens and the relationship between preoperative computed tomography imaging and residual inflammation findings were evaluated. Results: All patients who had successful interval appendectomy received laparoscopic appendectomy as an elective surgery. Postoperative complications included superficial surgical site infection in two patients (4%). Pathological assessment of the resection specimens of interval appendectomy revealed acute inflammation and chronic inflammation in 11 patients (22%) and 25 patients (49%), respectively. Preoperative computed tomography imaging showed elevated peri-appendiceal fat tissue concentration and residual abscesses in 11 patients (22%) and five patients (10%), respectively. Residual inflammation was significantly higher in patients who had exhibited elevated peri-appendiceal fat tissue concentration on preoperative computed tomography imaging. Conclusions: Despite the absence of abdominal pain or other inflammatory symptoms, 70% patients showed pathological evidence of ongoing inflammation even after 3 months of conservative treatment. Given the high percentage of resection specimens showing acute or chronic appendicitis, interval appendectomy should be performed for complete elimination of inflammation.},
 year = {2022}
}

Copy | Download

TY  - JOUR
T1  - Histopathological Analysis as Support for the Applicaibility of Interval Appendectmy: A Single-Center Retrospective Study
AU  - Ryosuke Kita
AU  - Daisuke Yamashita
AU  - Koji Kitamura
AU  - Masato Kondo
AU  - Hiroyuki Kobayashi
AU  - Kenji Uryuhara
AU  - Hiroki Hashida
AU  - Satoshi Kaihara
Y1  - 2022/03/03
PY  - 2022
N1  - https://doi.org/10.11648/j.js.20221002.11
DO  - 10.11648/j.js.20221002.11
T2  - Journal of Surgery
JF  - Journal of Surgery
JO  - Journal of Surgery
SP  - 57
EP  - 61
PB  - Science Publishing Group
SN  - 2330-0930
UR  - https://doi.org/10.11648/j.js.20221002.11
AB  - Background: The management of perforated appendicitis with abscess, including interval appendectomy, remains controversial. Materials and Methods: The study was a retrospective analysis of patients diagnosed as having perforated appendicitis with abscess who were treated in our hospital between April 2014 and December 2020. A total of 51 patients who underwent successful interval appendectomy protocol were included. Residual pathological inflammation in the resection specimens and the relationship between preoperative computed tomography imaging and residual inflammation findings were evaluated. Results: All patients who had successful interval appendectomy received laparoscopic appendectomy as an elective surgery. Postoperative complications included superficial surgical site infection in two patients (4%). Pathological assessment of the resection specimens of interval appendectomy revealed acute inflammation and chronic inflammation in 11 patients (22%) and 25 patients (49%), respectively. Preoperative computed tomography imaging showed elevated peri-appendiceal fat tissue concentration and residual abscesses in 11 patients (22%) and five patients (10%), respectively. Residual inflammation was significantly higher in patients who had exhibited elevated peri-appendiceal fat tissue concentration on preoperative computed tomography imaging. Conclusions: Despite the absence of abdominal pain or other inflammatory symptoms, 70% patients showed pathological evidence of ongoing inflammation even after 3 months of conservative treatment. Given the high percentage of resection specimens showing acute or chronic appendicitis, interval appendectomy should be performed for complete elimination of inflammation.
VL  - 10
IS  - 2
ER  -

Copy | Download

Author Information

Ryosuke Kita

Department of Surgery, Kobe City Medical Center General Hospital, Kobe, Japan
Daisuke Yamashita

Department of Pathology, Kobe City Medical Center General Hospital, Kobe, Japan
Koji Kitamura

Department of Surgery, Kobe City Medical Center General Hospital, Kobe, Japan
Masato Kondo

Department of Surgery, Kobe City Medical Center General Hospital, Kobe, Japan
Hiroyuki Kobayashi

Department of Surgery, Kobe City Medical Center General Hospital, Kobe, Japan
Kenji Uryuhara

Department of Surgery, Kobe City Medical Center General Hospital, Kobe, Japan
Hiroki Hashida

Department of Surgery, Kobe City Medical Center General Hospital, Kobe, Japan
Satoshi Kaihara

Department of Surgery, Kobe City Medical Center General Hospital, Kobe, Japan

Download PDF

Sections

Plain Text BibTeX RIS

APA Style

Ryosuke Kita, Daisuke Yamashita, Koji Kitamura, Masato Kondo, Hiroyuki Kobayashi, et al. (2022). Histopathological Analysis as Support for the Applicaibility of Interval Appendectmy: A Single-Center Retrospective Study. Journal of Surgery, 10(2), 57-61. https://doi.org/10.11648/j.js.20221002.11

Copy | Download

ACS Style

Ryosuke Kita; Daisuke Yamashita; Koji Kitamura; Masato Kondo; Hiroyuki Kobayashi, et al. Histopathological Analysis as Support for the Applicaibility of Interval Appendectmy: A Single-Center Retrospective Study. J. Surg. 2022, 10(2), 57-61. doi: 10.11648/j.js.20221002.11

Copy | Download

AMA Style

Ryosuke Kita, Daisuke Yamashita, Koji Kitamura, Masato Kondo, Hiroyuki Kobayashi, et al. Histopathological Analysis as Support for the Applicaibility of Interval Appendectmy: A Single-Center Retrospective Study. J Surg. 2022;10(2):57-61. doi: 10.11648/j.js.20221002.11

Copy | Download

@article{10.11648/j.js.20221002.11,
  author = {Ryosuke Kita and Daisuke Yamashita and Koji Kitamura and Masato Kondo and Hiroyuki Kobayashi and Kenji Uryuhara and Hiroki Hashida and Satoshi Kaihara},
  title = {Histopathological Analysis as Support for the Applicaibility of Interval Appendectmy: A Single-Center Retrospective Study},
  journal = {Journal of Surgery},
  volume = {10},
  number = {2},
  pages = {57-61},
  doi = {10.11648/j.js.20221002.11},
  url = {https://doi.org/10.11648/j.js.20221002.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20221002.11},
  abstract = {Background: The management of perforated appendicitis with abscess, including interval appendectomy, remains controversial. Materials and Methods: The study was a retrospective analysis of patients diagnosed as having perforated appendicitis with abscess who were treated in our hospital between April 2014 and December 2020. A total of 51 patients who underwent successful interval appendectomy protocol were included. Residual pathological inflammation in the resection specimens and the relationship between preoperative computed tomography imaging and residual inflammation findings were evaluated. Results: All patients who had successful interval appendectomy received laparoscopic appendectomy as an elective surgery. Postoperative complications included superficial surgical site infection in two patients (4%). Pathological assessment of the resection specimens of interval appendectomy revealed acute inflammation and chronic inflammation in 11 patients (22%) and 25 patients (49%), respectively. Preoperative computed tomography imaging showed elevated peri-appendiceal fat tissue concentration and residual abscesses in 11 patients (22%) and five patients (10%), respectively. Residual inflammation was significantly higher in patients who had exhibited elevated peri-appendiceal fat tissue concentration on preoperative computed tomography imaging. Conclusions: Despite the absence of abdominal pain or other inflammatory symptoms, 70% patients showed pathological evidence of ongoing inflammation even after 3 months of conservative treatment. Given the high percentage of resection specimens showing acute or chronic appendicitis, interval appendectomy should be performed for complete elimination of inflammation.},
 year = {2022}
}

Copy | Download

TY  - JOUR
T1  - Histopathological Analysis as Support for the Applicaibility of Interval Appendectmy: A Single-Center Retrospective Study
AU  - Ryosuke Kita
AU  - Daisuke Yamashita
AU  - Koji Kitamura
AU  - Masato Kondo
AU  - Hiroyuki Kobayashi
AU  - Kenji Uryuhara
AU  - Hiroki Hashida
AU  - Satoshi Kaihara
Y1  - 2022/03/03
PY  - 2022
N1  - https://doi.org/10.11648/j.js.20221002.11
DO  - 10.11648/j.js.20221002.11
T2  - Journal of Surgery
JF  - Journal of Surgery
JO  - Journal of Surgery
SP  - 57
EP  - 61
PB  - Science Publishing Group
SN  - 2330-0930
UR  - https://doi.org/10.11648/j.js.20221002.11
AB  - Background: The management of perforated appendicitis with abscess, including interval appendectomy, remains controversial. Materials and Methods: The study was a retrospective analysis of patients diagnosed as having perforated appendicitis with abscess who were treated in our hospital between April 2014 and December 2020. A total of 51 patients who underwent successful interval appendectomy protocol were included. Residual pathological inflammation in the resection specimens and the relationship between preoperative computed tomography imaging and residual inflammation findings were evaluated. Results: All patients who had successful interval appendectomy received laparoscopic appendectomy as an elective surgery. Postoperative complications included superficial surgical site infection in two patients (4%). Pathological assessment of the resection specimens of interval appendectomy revealed acute inflammation and chronic inflammation in 11 patients (22%) and 25 patients (49%), respectively. Preoperative computed tomography imaging showed elevated peri-appendiceal fat tissue concentration and residual abscesses in 11 patients (22%) and five patients (10%), respectively. Residual inflammation was significantly higher in patients who had exhibited elevated peri-appendiceal fat tissue concentration on preoperative computed tomography imaging. Conclusions: Despite the absence of abdominal pain or other inflammatory symptoms, 70% patients showed pathological evidence of ongoing inflammation even after 3 months of conservative treatment. Given the high percentage of resection specimens showing acute or chronic appendicitis, interval appendectomy should be performed for complete elimination of inflammation.
VL  - 10
IS  - 2
ER  -

Copy | Download