The Role and Value of Videolaparoscopy in the Diagnostic and Therapeutic Algorithm in Patients with Acute Appendicitis

B.O. Matviychuk, A.D. Kvit

Abstract


Introduction. Appendectomy as a method of surgical treatment of patients with acute appendicitis can be attributed to the dominant urgent surgery among all interventions in emergency abdominal surgery. The part of these operations in surgical hospitals in Ukraine and abroad is 30–65 %.
Objective of this study is to determine the role and importance of videolaparoscopy in diagnostic and therapeutic algorithm in patients with acute appendicitis.
Materials and Methods. We analyzed outcomes of surgical treatment of 1345 patients with a clinical diagnosis of acute appendicitis, who were treated in the clinic of surgery and endoscopy of FPGE based on municipal city clinical emergency hospital of Lviv in 2008–2012.
Results of the Study and Their Discussion. Due to an analysis of the effects of treatment of selected patients with acute abdominal pathology we proved the feasibility and the need to include into diagnostic and therapeutic algorithm techniques of videolaparoscopic survey. It is noted that among all patients in whom we used videolaparoscopy, women dominate 66.7 %). We processed and analyzed the main features of the endoscopic view in these patients.
Conclusions. It is found that in 12.7 % of patients clinical picture of acute appendicitis is atypical, which complicates the differential diagnosis with other diseases. It is also proved that videolaparoscopy as part of diagnostic and therapeutic algorithm in patients with atypical form of acute appendicitis gives you the opportunity to verify the inflammatory changes in the appendix in 63.7 % of patients, and in 36.3 % — to avoid unnecessary appendectomy.


Keywords


acute appendicitis; videolaparoscopy; appendectomy; diagnostic and therapeutic algorithm

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DOI: https://doi.org/10.22141/1997-2938.1.24.2014.82865

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