Non-surgical and Surgical Treatment of Acute Appendicitis in Children. Literature Review of the last 5 Years
No Thumbnail Available
Date
2021
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Rīgas Stradiņa universitāte
Rīga Stradiņš University
Rīga Stradiņš University
Abstract
"Ķirurģiskas un ne-ķirurģiskas ārstēšanas metodes bērniem ar akūtu apendicītu. Pēdējo 5 gadu literatūras apskats"
Akūts apendicīts ir biežākais "akūta vēdera" iemesls bērnu populācijā. Agrīna apendektomija ilgstoši bija ārstēšanas zelta standarts, kā rezultātā negatīvo apendektomiju skaits bērniem sastādīja vidēji 10-20%. Arvien lielāku nozīmi akūta apendicīta ārstēšanā bērniem un pieaugušajiem iegūst konservatīvas terapijas iespējas. Šī darba mērķis ir izpētīt un salīdzināt esošos datus par akūta apendicīta ķirurģiskas un konservatīvas ārstēšanas rezultātiem, kas atrodami zinātniskajā literatūrā pēdējo 5 gadu laikā.
Komplicēts un nekomplicēts apendicīts jāuzskata par divām klīniski atšķirīgām slimībām, kuru precīza atšķiršana ir izaicinājums, kas ne vienmēr ļauj izvēlēties optimālāko terapiju.
Literatūrā atrodamie pētījumi atšķiras pēc sava veida, terapijā izmantotajiem antibakteriālajiem līdzekļiem, novērošanas ilguma u.c. parametriem. Šobrīd konservatīva terapija neuzrāda priekšrocības, salīdzinot ar ķirurģisku terapiju, taču konservatīva terapija ir uzskatāma par drošu terapijas alternatīvu bērniem līdz 7 gadu vecumam.
Komplicēta apendicīta gadījumā izvēles metode joprojām ir agrīna apendektomija samazināta komplikāciju attīstīšanās riska un veselības aprūpes izdevumu dēļ.
“Non-surgical and surgical treatment of acute appendicitis in children. Literature review of the last 5 years.” Acute appendicitis presents the most common cause of acute abdomen in pediatric population. For years early appendectomy was the gold standard. But false appendectomy rates have still been high with 10-20% in children. Over the past years non-surgical management of acute appendicitis in pediatric and adult population gained importance. The purpose of this literature review is to investigate and compare current literature on surgical and non-surgical treatment of acute appendicitis in children of the last 5 years. Complicated and uncomplicated appendicitis must be looked at as 2 different entities. Yet clinical differentiation between complicated and uncomplicated appendicitis is a challenge impeding optimal treatment. Present studies vary in study design, NOM protocols and selection criteria for participants. Currently non-operative management of uncomplicated appendicitis shows no superiority to surgical management although NOM can display a safe alternative in children > 7 years old. Preferred management of complicated appendicitis in children remains early appendectomy due to less complication risk and decreased health care costs.
“Non-surgical and surgical treatment of acute appendicitis in children. Literature review of the last 5 years.” Acute appendicitis presents the most common cause of acute abdomen in pediatric population. For years early appendectomy was the gold standard. But false appendectomy rates have still been high with 10-20% in children. Over the past years non-surgical management of acute appendicitis in pediatric and adult population gained importance. The purpose of this literature review is to investigate and compare current literature on surgical and non-surgical treatment of acute appendicitis in children of the last 5 years. Complicated and uncomplicated appendicitis must be looked at as 2 different entities. Yet clinical differentiation between complicated and uncomplicated appendicitis is a challenge impeding optimal treatment. Present studies vary in study design, NOM protocols and selection criteria for participants. Currently non-operative management of uncomplicated appendicitis shows no superiority to surgical management although NOM can display a safe alternative in children > 7 years old. Preferred management of complicated appendicitis in children remains early appendectomy due to less complication risk and decreased health care costs.
Description
Medicīna
Medicine
Veselības aprūpe
Health Care
Medicine
Veselības aprūpe
Health Care
Keywords
akūts apendicīts bērniem, ķirurģiska un konservatīva akūta apendicīta terapija bērniem, konservatīva apendicīta terapija bērniem, komplicēts un nekomplicēts apendicīts bērniem., acute appendicitis in children, surgical and non-surgical treatment of acute appendicitis in children, non-operative management of appendicitis in children, complicated and uncomplicated appendicitis in children.