Ankara Üniversitesi Tıp Fakültesi Mecmuası

0365-8104 1307-5608

Ankara University

General Surgery

Genel Cerrahi

An Analysis of 287 Patients Operated With a Preoperative Diagnosis of Acute Appendicitis

Akut Apandisit Ön Tanısı İle Ameliyat Edilen 287 Hastanın Analizi

Yılmaz

Mehmet Uğur

Bulanık Devlet Hastanesi

09 30 1986

39 3 265 278 07 01 1986 09 30 1986

1947

Ankara Üniversitesi Tıp Fakültesi Mecmuası

Following results have been obtained by an analysis of 287 patients operated with a preoperative diagnosis of acute appendicitis, at the Department of Surgery, University of Ankara School of Medicine, between January 1, 1980 and January 1, 1981, Of the operated patients, 165 (57.5 96) were male and 122 (42.5 Ve) were female. The age of the patients ranged from 2 to 95 years with a mean age of 25.6 years. Most of the patients were in 11-20 year age group. The negative appendectomy rate (diagnostic error) was 22.6 W. The ratio of pregnant woment was 1.39 Ye, and in this group a higher ratio of perforated appendicitis has been observed. At operations, mostiy vertical incisions have been prefered, although such vertical incisions have enhanced complications such as wound infections. No positive effect of peritoneal drainage on the prognosis has been observed in the patients with perforated appendicitis or with localised peritonitis, but wound infections have been increased. Most of the postoperative complications were wound suppurations, and the overall morbidity was 244 W. The mortality rate was 0.69 ©, and the average period of hospital stay was 7.9 days.

nkara Üniversitesi Tıp Fakültesi Genel Cerrahi Kliniğinde 1 Ocak 1980 ile 1 Ocak 1981 tarihleri arasında akut apandisit ön tanısı ile ameliyat edilen 287 hastanın analizinden aşağıdaki sonuçlar elde edilmiştir : Ameliyat edilen hastaların 165'i (7X 57.5) erkek ve geri kalan 122'si (46 42.5) kadındır. Yaş ortalaması 25.6 olup, en küçük hasta iki, en yaşlı hasta 95 yaşındadır. Hastaların çoğunluğu 11-20 yaş gurubunda bulunmaktadır. Negatif appendektomi oranı (tanı hastası) 6 22.6'dır. Gebe hastaların oranı 1.39 olup, bu gurupta perfore apandisit oranı daha yüksek olarak gözlenmiştir. Ameliyat girişimlerinde özellikle vertikal kesiler tercih edilmiş olup, bu tip kesiler yara enfeksiyonlarını arttırmışlardır. Perfore apandisitli ve lokalize peritonitli hastalarda yara drenajının prognoz üzerine hiçbir olumlu etkisi görülmediği gibi, bunlar aksine yara enfeksiyonunu arttırmıştır. Ameliyat sonu komplikasyonların büyük çoğunluğunu yara süpürasyonları oluşturmaktadır (96 14.63). Toplam morbidite oranı W 224, mortalite oranı © 0.69 ve ortalama hastanede kalma süresi 7.9 gündür.

AKUT APANDİSİT appendektomi histopatolojik

ACUTE APPENDICITIS appendectomy histopathological

1. Akın H : Ana çizgileri ile akut karın. Cerrahi (Ders Kitabı) 1, baskı, Ankara, AÜ.TEF. Yayınları, Ankara, A.Ü. Basımevi, 1975, 5. 381-418. i

2. Babcock JR, and MeKinley WM : Acute appendicitis : An analysis of 1662 consecutive cases, Ann Surg 150 : 131-141, 1959.

3. Barnes BC, Behringer GE, Wheelook FC, and Wilkins EM : Treatment of appendicitis at the. Massachusetts General Hospital (1937-1959). JAMA 180; 226, 1962.

4, Befeler D : Recurrent appendicitis : Incidence and prophylaxis. Arch Surg 89 : 666-68, 1964.

5.Boles ET Jr, Ireton Rj and Clatworthy HW Jr : Acute appendicitis in children. Arch Surg 79 : 447-54, 1959.

6. Bothe WA : Appendectomy. Surg Clin North Am 37 : 1615-23, 1957.

7. Bradham RR, Kredel WE and Charleston JF : Acute appendicitiş with perforation. JAMA 173 ; 1342-44, 1960,

8. Brook I : Bacterial studies of peritoneal cavity and postoperative surgical wound drainage following perforated appendix in children. Ann Surg 192 ; 2068-12, 1980.

9. Brumer M : Appendicitis : Seasonel incidence and postoperative wound infection, Br J Surg 57 : 93-99, 1970.

10. Carey LC, and Catalano PW : The Linde's Operative Gynecology. Philadelphia, JB Lippincott Co., 1977 : 407-14.

11. Collins DC : 71 000 human appendix specimens (A final report of summarizing 40 years' study) Am J Proctol 4 : 365-81, 1963.

12. Condon RE : Appendicitis. In : Sebiston DC, eds. Davis-Christopher Textbook of Surgery. Philadelphia : WB Saunders Co., 1977 : 1062-78.

13. Creese. PG : The first appendectomy. Surg Gynecol Obstet 97 : 6843-51, 1958.

14. Cruise PJ : Incidence of wound infections on the surgical services, Surg Clin North Am 55 : 1289-75, 1975.

15. Cunningham FG, McCubbin JH : Appendicitis Complicating Pregnancy. Obstet Gynecol 45 : 415-20, 1974.

16. Donovan IA, Ellis D, Gatehouse D, et al : One-dose antibotic prophylaxis against wound infection after appendicectomy : A randomized trial of clindamycin, cefazolin sodium, and a placebo, Br J Surg 86 : 193-096, 1970.

17. Doraiswamy NJ : Leucocyte count in the diagnosis and prognosis of acute appendicitis in children, Br J Surg 68 : 782-84, 1979,

18. Farber BW and Wenzel R : Postoperative wound infection rates : Results of prospective statewide surveillance. Am J Surg 140 : 343-468, 1980.

19. Gilmore OJA, Brodribb AJM, Browett JP, et al : Appendicitis and mimicking conditions : A prospective study. Lancet 2 : 421-24, 1975.

20. omez A and Wood M : Acute appendicitis during pregnancy. Am J Surg 137: 180-83, 1978.

21. Graham JM, Pokomy WJ, Harber WJ : Acute appendicitis in preschool age children. Am J Surg 138: 244-50, 1980. 22. Grosfeld JL, Solit RAW : Prevention of Wound infection in perforated appendiditis : Experience with delayed primay Wound closure. Ann Surg 168 : 881, 1908.

23. Haller JA, Shaker lJ, Donahoo JS, et al: Peritoneal drainage versus non-drainage for generalized peritonitis İrom ruptured appendicitis in children. Ann Surg 177 : 595-600, 1973.

24. Hermann G ;: Intraperitoneal drainage. Surg Clin North Am 49 : 1279-88, 1988.

25. Janik JS and Firor HV : Pediatric appendicitis, A 20 year study of 1 640 children at Cook Conty (llincis) Hospital. Arch Surg 144 : 1717-19, 1979.

26. Lee PWR : The leucocyte count in acute appendicitis. Br J Surg 60 : 618, 1978.

27. Leger L, Bosgiraud F and Louvel A : Reflexions sur un& series de cent appendicectomies d'urgence, Chirurgie 105 : 926-29, 1978.

28. Lewis FR. Holeroft JW, Bosy J and Dunphy JE: Appendicitis. A critical review of diagnosis and treatment in 1000 cases. Arch Surg 1190: 8677-84, 1975.

29. Maddox JR, Johnson WW and Sergeant CK : Appendectomios in & childron's hospital. Arch Surg 89: 223-25, 1904.

30. Marchildon MB, Dudgeon DL : Perforated appendicitis : Current experience â children hospital. Ann Surg 185 : 84-87, 1977. ç

31. Mason xH, Byrne M, Gav FC ; Surgery of the vermiform appendix. Surg Clin North Am 57 : 1303-15, 1977.

32. Mittelpunkt A ve Nora PF ; Current features in the treatment of acute appen dicitis, An analysis of 1000 consecutive cases. Surgery 60: 971-75, 1966.

33. Reftery AT : The value of the leukocyte count in the diagnosis ol acute appendicitis. Br J Surg 63 : 143-44, 1976.

34. Scher KS and Coil JA ; The continuing challenge of perforating appendicitis. Surg Gynecol Obstet 150 : 535-3B, 1880.

35. Stephenson J and Snooddy WT : Appendiceal leşions : Observations in 4 000 appendectomies. Arch Surg 83 ; 310-114, 1801.

38. Stone HH, Sanders SL and Martin JD jr: Perforated appendicitis in children, Surgery 69 : 8673-79, 1971.

37. Thomas DR : Conservative management of the appendix mass. Surgery 73 : 677- 80, 1973.

38. Türkiye Sağlık İstatistik Yıllığı, 1975-1978. Sağlık ve Sosyal Yardım Bakanlığı, Sağlık Propagandası ve Tıbbi İstatistik Genel Müdürlüğü. Ankara, 1980.