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  • Key words: Abdominal pain — Appendicitis — negative appendicectomy rate — Histology  (1)
  • Sphincter spasm  (1)
  • 2000-2004  (2)
  • 1970-1974
Collection
Keywords
Publisher
Years
  • 2000-2004  (2)
  • 1970-1974
Year
  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Techniques in coloproctology 4 (2000), S. 79-81 
    ISSN: 1128-045X
    Keywords: Key words Anal stenosis ; Sphincter spasm ; Radical hemorrhoidectomy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract: Used in the treatment of gross circumferential hemorrhoidal prolapse. Whitehead hemorrhoidectomy is technically more demanding and has slightly more complications than four-quadrant hemorrhoidectomy. The former, however, offers a radical cure and is the better operation whereas the latter is often associated with considerable remaining skin tags and areas of residual hemorrhoidal tissue. Following the Whitehead operation, we have observed fewer complications in older patients compared to younger patients. Case notes and follow-up data of all patients who underwent a Whitehead hemorrhoidectomy in the period October 1995 to November 1999 were reviewed, and clinical presentation and outcome were analyzed. The study group consisted of 11 patients (8 males, 3 females), of median age 58 years (range, 41–,75 years). The median operation time was 30 min (range, 15–40 min). The median hospital stay was 3 days (range, 2–15 days). There was only early and one late complication, both with minimal related morbidity. In both these patients, appropriate treatment resulted in complete recovery. All othera patients had an uneventful course with no residual symptoms at the last visit. Elderly patients may be less prone to developing significant sphicter spasm due to a generally more lax sphincter tone. Therefore, they may be at less risk of suture line ischemia, breakdown and stenosis.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-2218
    Keywords: Key words: Abdominal pain — Appendicitis — negative appendicectomy rate — Histology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Healthy-looking appendixes are often removed at laparoscopy for suspected appendicitis. This practice may have adverse secondary effects. Methods: We reviewed the literature for the years 1978 to 1998 to analyze the negative appendectomy rates, complication rates, the accuracy of laparoscopic appendix assessment, and the incidence of false negative diagnosis of appendicitis at surgical and gynecological laparoscopy. Results: The respective negative appendectomy rates were 22% and 15% in studies that compared laparoscopic with open appendectomy. The appendix was left in situ in 37% of 4,281 surgical diagnostic laparoscopies. There were instances of missed appendicitis among the 3,367 gynecological diagnostic laparoscopies performed on women for lower abdominal pain, and there were 188 appendectomies in this group. Studies comparing the macroscopic appearance of the appendix at operation with microscopic findings from the excised specimen had a false negative error rate of 3%. Conclusions: Contrary to general opinion, there is no substantial evidence to support the assumption that the macroscopic diagnosis of appendicitis is unreliable. High rates of conflicting diagnoses of excision specimens suggest that endoappendicitis has little clinical significance. At present, negative appendectomy rates are considerably higher for laparoscopic appendectomy than for the open approach. The role of diagnostic laparoscopy in suspected appendicitis should be reconsidered. It may be useful in particular subgroups of patients, but it is no substitute for good clinical judgment. Furthermore, it is not always necessary to perform an incidental appendectomy.
    Type of Medium: Electronic Resource
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