Brunner M, Lapins P, Langheinrich M, Baecker J, Krautz C, Kersting S, Grützmann R, Maak M, Weber G (2019)
Publication Type: Journal article
Publication year: 2019
DOI: 10.1007/s00384-019-03453-5
Purpose: Non-operative management of acute uncomplicated appendicitis has shown promising results but might carry the risk of delayed diagnosis of premalignant or malignant appendiceal tumors found by chance in 0.7–2.5% of appendiceal specimen after appendectomy. Purpose of this study was to analyze whether appendiceal tumors are associated with a complicated appendicitis and to determine risk factors for appendiceal neoplasm and malignancy in patients with acute appendicitis. Methods: We performed a retrospective analysis of 1033 adult patients, who underwent appendectomy for acute appendicitis from 2010 to 2016 at the University hospital Erlangen. Data included patients’ demographics; comorbidities; pre-, intra- and postoperative findings; and histopathological results. Complicated appendicitis was defined in the presence of perforation or abscess. Results: Appendiceal neoplasm respectively malignancy rate was 2.8% respectively 1.5%. Using univariate analysis, we identified seven risk factors at least for appendiceal neoplasm or malignancy: age, ASA, C-reactive protein, appendiceal diameter, perforation, intraoperative perithyphilitic abscess, and complicated appendicitis. Risk for appendiceal neoplasm or malignancy was 4.4% respectively 2.7% in complicated acute appendicitis compared to 2.0% respectively 1.0% in uncomplicated appendicitis (p = 0.043 respectively p = 0.060). In multivariate analysis, age ≥ 50 years and a diameter of the appendix in the sonography ≥ 13 mm were independent risk factors predicting the presence of appendiceal neoplasm and malignancy. Conclusion: Among patients with appendicitis, there are relevant risk factors predicting appendiceal tumors, especially age and appendiceal diameter in sonography. But the identified risk factors have a low sensitivity and specificity, so obtaining a confident preoperative diagnosis is challenging.
APA:
Brunner, M., Lapins, P., Langheinrich, M., Baecker, J., Krautz, C., Kersting, S.,... Weber, G. (2019). Risk factors for appendiceal neoplasm and malignancy among patients with acute appendicitis. International Journal of Colorectal Disease. https://doi.org/10.1007/s00384-019-03453-5
MLA:
Brunner, Maximilian, et al. "Risk factors for appendiceal neoplasm and malignancy among patients with acute appendicitis." International Journal of Colorectal Disease (2019).
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