Low intra-operative diagnostic accuracy does not affect postoperative treatment of acute appendicitis

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dc.contributor.authorVinck, Eric
dc.contributor.authorVillarreal, Ricardo A.
dc.contributor.authorLuna-Jaspe, Carlos
dc.contributor.authorCabrera, Luis F.
dc.contributor.authorPeterson, Tim F.
dc.contributor.authorBernal, Felipe
dc.contributor.authorRoa, Carmen L.
dc.date.accessioned2020-05-13T21:27:37Z
dc.date.available2020-05-13T21:27:37Z
dc.date.issued2019
dc.description.abstractenglishBackground: The intra-operative classification of appendicitis defines postoperative treatment. The correct designation can influence patient recovery, complications and hospital costs. Recent research has shown that intra-operative classification criteria varies among surgeons, and is not always the same as the pathologist’s report. Classification accuracy can lower costs by preventing unnecessary treatment or sub-optimal interventions. Methods: During a period of 4 months, N = 133 appendix specimens were received and evaluated by the pathology department of a single teaching hospital. Five surgeons extracted the specimens and one experienced pathologist drew the histopathology reports. A comparison between the surgeons’ classifications and the pathologist’s was made. Classification accuracy was determined and statistical analyses was performed using chi-square, and p values were obtained. A p < 0.05 was considered significant. Results: A total of N = 133 specimens were obtained, 127 belonged to patients following emergency surgery due to acute abdominal pain; the other six were from elective hemi-colectomies for right colonic adenocarcinomas, and were not included. Of the 127 specimens analyzed, 14 (11%) were negative, 21 (16.5%) were edematous, 81 (63.7%) were phlegmonous and 11 (8.6%) were gangrenous. A total of 18 (14%) perforated appendices were also reported. Surgical accuracy was 60.6% (N = 67) with a statistically significant p < 0.001. Only five patients with incorrect intraoperative classifications received unnecessary or lacked treatment. Conclusions: An overall accuracy of 60.6% is seen when the surgical classification is compared to the pathological classification. Although the surgeons’ accuracy is low when comparing intra-operative versus histopathological classification, this variation in designation does not affect postoperative treatment significantly.eng
dc.format.mimetypeapplication/pdf
dc.identifier.doihttps://doi.org/10.1080/00015458.2019.1642578
dc.identifier.issn0001-5458
dc.identifier.urihttps://hdl.handle.net/20.500.12495/2727
dc.language.isoeng
dc.publisherTaylor and Francis Onlinespa
dc.publisher.journalActa Chirurgica Belgicaspa
dc.relation.ispartofseriesActa Chirurgica Belgica, 0001-5458, 2019spa
dc.relation.urihttps://www.tandfonline.com/doi/full/10.1080/00015458.2019.1642578?scroll=top&needAccess=true
dc.rights.creativecommons2019
dc.rights.localAcceso cerradospa
dc.subject.decsApéndicespa
dc.subject.decsDiagnósticospa
dc.subject.decsCirugíaspa
dc.subject.keywordsAppendicitisspa
dc.subject.keywordsappendectomyspa
dc.subject.keywordsInflammation accuracyspa
dc.titleLow intra-operative diagnostic accuracy does not affect postoperative treatment of acute appendicitisspa
dc.title.translatedLow intra-operative diagnostic accuracy does not affect postoperative treatment of acute appendicitisspa
dc.typearticlespa
dc.type.hasversioninfo:eu-repo/semantics/publishedVersion
dc.type.localartículospa

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