Global attitudes in the management of acute appendicitis during COVID-19 pandemic: ACIE Appy Study

B. Ielpo, M. Podda, G. Pellino, F. Pata, R. Caruso, G. Gravante, S. Di Saverio, Benedetto Ielpo, Mauro Podda, Gianluca Pellino, Francesco Pata, Riccardo Caruso, Gianpiero Gravante, Salomone Di Saverio, Gaetano Gallo, Rashid Lui, Adam Orengia, Aditya Chowdary, Aditya Kulkarni, Adnan KuvvetliAdolfo Navarro, Adolfo Pisanu, Adrian Smith, Adriana Cavero Ibiricu, Aeris Jane D. Nacion, Ahmad Alsaleh, Ahmad Alhazmi, Ahmad Elmabri, Ajaz Wani, Ahmet Rencuzogullari, Aingeru Sarriugarte Lasarte, Ainhoa Valle Rubio, Akshay Bavikatte, Akshay Kumar, Al radjid Jamiri, Alain Michel Alvarado Padilla, Alban Cacurri, Alberto de San Ildefonso, Alberto Porcu, Alberto Sartori, Aldo Rocca, Alejandro Paz Yáñez, Alejandro Becaria, Alejandro Solís-Peña, Aleksandar Sretenović, Alex Urbistondo, Alfonso Bandin, Alfonso Najar, Alessandro De Luca, Alex Boddy, Alexandros Charalabopoulos, Alexios Tzivanakis, Alfonso Amendola, Alfredo Ramirez Gutierrez de Velasco, Ali Cihat Yildirim, Alice Frontali, Alpha Oumar Toure, Alvaro García-Granero, Amaia Martínez Roldan, Amaia Sanz Larrainzar, Amila Sanjiva Ratnayake, Ana María Gonzalez-Ganso, Ana M. Minaya-Bravo, Andre Das, Andrea Bondurri, Andrea Costanzi, Andrea Lucchi, Andrea Mazzari, Andrea Musig, Andrea Peloso, Andrea Piano, Andrea Police, Andrei Mihailescu, Andrés Pouy, Angela Romano, Angelo Iossa, Anna Carmen Leonetti, Anna Guariniello, Anna Isaac, Anna Pia Delli Bovi, Antonella Chessa, Antonella Tromba, Antonio Álvarez Martínez, Antonio Brillantino, Antonio Caira, Antonio Castaldi, Antonio Ferronetti, Antonio Giuliani, Antonio Prestera, Antonio Ramos De la Medina, Antonio Tarasconi, Antonino Tornambè, Arcangelo Picciariello, Argyrios Ioannidis, Ari Leppäniemi, Arshad Khan, Arshad Rashid, Arteaga Luis Eduardo Pérez-Sánchez, Ashok Mittal, Ashrarur Rahman Mitul

Результат исследований: Материалы для журналаСтатьярецензирование

18 Цитирования (Scopus)

Аннотация

Background: Surgical strategies are being adapted to face the COVID-19 pandemic. Recommendations on the management of acute appendicitis have been based on expert opinion, but very little evidence is available. This study addressed that dearth with a snapshot of worldwide approaches to appendicitis. Methods: The Association of Italian Surgeons in Europe designed an online survey to assess the current attitude of surgeons globally regarding the management of patients with acute appendicitis during the pandemic. Questions were divided into baseline information, hospital organization and screening, personal protective equipment, management and surgical approach, and patient presentation before versus during the pandemic. Results: Of 744 answers, 709 (from 66 countries) were complete and were included in the analysis. Most hospitals were treating both patients with and those without COVID. There was variation in screening indications and modality used, with chest X-ray plus molecular testing (PCR) being the commonest (19·8 per cent). Conservative management of complicated and uncomplicated appendicitis was used by 6·6 and 2·4 per cent respectively before, but 23·7 and 5·3 per cent, during the pandemic (both P < 0·001). One-third changed their approach from laparoscopic to open surgery owing to the popular (but evidence-lacking) advice from expert groups during the initial phase of the pandemic. No agreement on how to filter surgical smoke plume during laparoscopy was identified. There was an overall reduction in the number of patients admitted with appendicitis and one-third felt that patients who did present had more severe appendicitis than they usually observe. Conclusion: Conservative management of mild appendicitis has been possible during the pandemic. The fact that some surgeons switched to open appendicectomy may reflect the poor guidelines that emanated in the early phase of SARS-CoV-2.
Язык оригиналаАнглийский
ЖурналBritish Journal of Surgery
DOI
СостояниеОпубликовано - 1 янв 2020

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