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- Title
SAGES guideline for the diagnosis and treatment of appendicitis.
- Authors
Kumar, Sunjay S.; Collings, Amelia T.; Lamm, Ryan; Haskins, Ivy N.; Scholz, Stefan; Nepal, Pramod; Train, Arianne T.; Athanasiadis, Dimitrios I.; Pucher, Philip H.; Bradley III, Joel F.; Hanna, Nader M.; Quinteros, Francisco; Narula, Nisha; Slater, Bethany J.
- Abstract
Background: Appendicitis is an extremely common disease with a variety of medical and surgical treatment approaches. A multidisciplinary expert panel was convened to develop evidence-based recommendations to support clinicians and patients in decisions regarding the diagnosis and treatment of appendicitis. Methods: A systematic review was conducted from 2010 to 2022 to answer 8 key questions relating to the diagnosis of appendicitis, operative or nonoperative management, and specific technical and post-operative issues for appendectomy. The results of this systematic review were then presented to a panel of adult and pediatric surgeons. Evidence-based recommendations were formulated using the GRADE methodology by subject experts. Results: Conditional recommendations were made in favor of uncomplicated and complicated appendicitis being managed operatively, either delayed (>12h) or immediate operation (<12h), either suction and lavage or suction alone, no routine drain placement, treatment with short-term antibiotics postoperatively for complicated appendicitis, and complicated appendicitis previously treated nonoperatively undergoing interval appendectomy. A conditional recommendation signals that the benefits of adhering to a recommendation probably outweigh the harms although it does also indicate uncertainty. Conclusions: These recommendations should provide guidance with regard to current controversies in appendicitis. The panel also highlighted future research opportunities where the evidence base can be strengthened.
- Subjects
UNITED States; ANTIBIOTICS; APPENDICITIS treatment; APPENDICITIS diagnosis; CONSERVATIVE treatment; MEDICAL protocols; APPENDECTOMY; POSTOPERATIVE care; PATIENT compliance; PATIENT education; MEDICAL information storage &; retrieval systems; HEALTH services accessibility; RESEARCH funding; MEDICAL personnel; CLINICAL decision support systems; CINAHL database; COMPUTED tomography; APPENDICITIS; DECISION making; TREATMENT effectiveness; DIGESTIVE organ surgery; SYSTEMATIC reviews; PROFESSIONS; MEDLINE; SURGICAL complications; ENDOSCOPIC gastrointestinal surgery; MEDICAL databases; REOPERATION; EVIDENCE-based medicine; ONLINE information services; EXPERTISE; LENGTH of stay in hospitals; SURGICAL site infections; LEGAL compliance; ABDOMINAL radiography; HEALTH care teams; DISEASE complications
- Publication
Surgical Endoscopy & Other Interventional Techniques, 2024, Vol 38, Issue 6, p2974
- ISSN
1866-6817
- Publication type
Article
- DOI
10.1007/s00464-024-10813-y