Komplike olmayan akut apandisitte medikal tedavi

Yıl 2020, Cilt: 1 Sayı: 2, 32 - 38, 25.08.2020

Ahmet Okuş Yusuf Tanrıkulu

Öz

Akut apandisit cerrahi acil ve akut batının en sık nedenidir. Akut apandisitin gecikmiş ve komplike hali olan plastrone apandisitte medikal tedavi acil cerrahiden daha düşük morbidite nedeni ile standart olarak uygulanmaktadır. Tedavi başarısı %90’ın üzerinde olup artık interval apendektomi önerilmemektedir. Komplike olmayan akut apandisitte medikal tedavi ise son yıllarda popüler olmuş bir tedavi şekli olup bu derlemede komplike olmayan apandisitte medikal tedavinin gelişim süreci kronolojik olarak ele alınmıştır.
Medline, Embase, Cochrane ve Web of Science veri tabanları incelendi. İngilizce olan ve komplike olmayan akut apandisitte medikal tedavi ile ilgili prospektif ve retrospektif çalışmalar incelemeye dahil edildi. Toplam 16 çalışma incelendi ve kronoloijk sıra içinde veriler irdelendi.
Retrospektif çalışmalarda medikal tedavinin başarısı daha yüksek ve nüks oranı daha düşük olarak bulunmasına rağmen prospektif çalışmaların büyük kısmında tedavi başarısı plastrone apandisite benzer şekilde yaklaşık %90 olarak oldukça yüksektir. Takip sırasında rekürrens oranı plastrone apandisitlerde yaklaşık %10 iken komplike olmayan apandisitlerin medikal tedavisinde yaklaşık %20’dir. Ancak medikal tedavi komplikasyon oranını artırmamaktadır. Bunun yanı sıra erken işe dönüş, komplikasyonların daha az olması nedeni ile akut apandisit tedavisinde alternatif bir tedavi olarak önerilebilir.

Anahtar Kelimeler

Akut apandisit, akut batın, apendektomi, medikal tedavi

Kaynakça

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