Manejo conservador y cirugía diferida en plastrón apendicular
DOI:
https://doi.org/10.62452/0dc0we13Keywords:
Laparoscopic surgery, conventional surgery, appendiceal abscess, postoperative morbidity, intra-abdominal infectionAbstract
Acute appendicitis has been the most common cause of abdominal pain requiring urgent surgery. Despite advances in techniques and perioperative management, complications and controversies regarding the ideal approach persist. Therefore, laparoscopic surgery has emerged due to its potential to optimize clinical and economic outcomes. Therefore, the present study analyzed the clinical effectiveness of laparoscopic surgery in acute appendicitis, focusing on postoperative complications, conversions to open surgery, and cost and hospital stay benefits. For the study, an analysis and review of academic studies comparing laparoscopic surgery with open surgery were conducted. The results showed that laparoscopic surgery resulted in faster recovery and a shorter hospital stay, with an approximate cost savings of $1,300 per patient. Furthermore, a 26.2% incidence of postoperative complications was recorded, with conversion to open surgery being the most frequent event. On the other hand, it was shown that percutaneous drainage and rational antibiotic management optimized complication control. It was concluded that laparoscopic surgery represents an effective and cost-effective standard for the management of acute appendicitis, although it requires therapeutic individualization and ongoing surgical training to minimize complications and conversions. Therefore, it is recommended to promote multicenter studies comparing different aspects of early appendectomy, antibiotic management, and tailored surgical therapy, especially in cases of localized perforations.
Downloads
References
Alotaibi, A. M., Alfawaz, M., Felemban, L., Moshref, L., & Moshref, R. (2022). Complicated appendicitis increases the hospital length of stay. Surgery open science, 9, 64–68. https://doi.org/10.1016/j.sopen.2022.05.006
Alvarado Rodríguez, S. C., & Quichimbo Sangurima, F. M. (2023). Apendicitis aguda: manejo quirúrgico vs antibiótico como opción de tratamiento. Revista Vive, 6(16), 45–54. https://doi.org/10.33996/revistavive.v6i16.205
David, A., Dodgion, C., Zein Eddine, S. B., Davila, D., Webb, T. P., & Trevino, C. M. (2020). Perforated appendicitis: Short duration antibiotics are noninferior to traditional long duration antibiotics. Surgery, 167(2), 475–477. https://doi.org/10.1016/j.surg.2019.08.007
Di Saverio, S., Podda, M., De Simone, B., Ceresoli, M., Augustin, G., Gori, A., Boermeester, M., Sartelli, M., Coccolini, F., Tarasconi, A., de’ Angelis, N., Weber, D. G., Tolonen, M., Birindelli, A., Biffl, W., Moore, E. E., Kelly, M., Soreide, K., Kashuk, J., … Catena, F. (2020). Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines. World Journal of Emergency Surgery, 15(27), 1–42. https://doi.org/10.1186/s13017-020-00306-3
Flores-Marín, K., Rodríguez-Parra, A., Trejo-Ávila, M., Cárdenas-Lailson, E., Delano-Alonso, R., Valenzuela-Salazar, C., Herrera-Esquivel, J., & Moreno-Portillo, M. (2021). Apendicectomía laparoscópica en pacientes con apendicitis aguda complicada con base apendicular comprometida: estudio de cohorte retrospectivo. Cirugia y cirujanos, 89(5), 651–656. https://doi.org/10.24875/CIRU.200009051
Kumar, S. S., Collings, A. T., Lamm, R., Haskins, I. N., Scholz, S., Nepal, P., Train, A. T., Athanasiadis, D. I., Pucher, P. H., Bradley, J. F., 3rd, Hanna, N. M., Quinteros, F., Narula, N., & Slater, B. J. (2024). SAGES guideline for the diagnosis and treatment of appendicitis. Surgical endoscopy, 38(6), 2974–2994. https://doi.org/10.1007/s00464-024-10813-y
Lamm, R., Kumar, S. S., Collings, A. T., Haskins, I. N., Abou-Setta, A., Narula, N., Nepal, P., Hanna, N. M., Athanasiadis, D. I., Scholz, S., Bradley, J. F., Train, A. T., Pucher, P. H., Quinteros, F., & Slater, B. (2023). Diagnosis and treatment of appendicitis: systematic review and meta-analysis. Surgical endoscopy, 37(12), 8933–8990. https://doi.org/10.1007/s00464-023-10456-5
León-Valladares, D., Barrio-Mateu, L. A., Cortés-Carmona, N., Fuentes-Lizana, G., Cabanas, A. M., Latorre-Progulakis, K., Fuentes-Guajardo, M., & Martín-Escudero, P. (2024). Determining factors of pulse oximetry accuracy: a literature review. Revista clinica espanola, 224(5), 314–330. https://doi.org/10.1016/j.rceng.2024.04.005
Mendoza-Zuchini, A., Arce-Polania, L. C., & Pérez-Rivera, C. J. (2023). Intravenous antibiotic therapy after laparoscopic appendectomy in acute complicated appendicitis: the patient clinical response is the key. Terapia antibiótica intravenosa posterior a apendicectomía por laparoscopia en apendicitis aguda complicada: la respuesta clínica del paciente es la clave. Cirugia y cirujanos, 91(4), 479–485. https://doi.org/10.24875/CIRU.21000557
Nikolovski, A., Tahir, S., & Mladenovikj, D. (2020). Complications after laparoscopic appendectomy for complicated appendicitis. Lietuvos chirurgija, 19(1–2), 34–41. https://www.journals.vu.lt/lietuvos-chirurgija/article/view/18366
Ramson, D. M., Gao, H., Penny-Dimri, J. C., Liu, Z., Khong, J. N., Caruana, C. B., Campbell, R., Jackson, S., & Perry, L. A. (2021). Duration of post-operative antibiotic treatment in acute complicated appendicitis: systematic review and meta-analysis. ANZ journal of surgery, 91(7-8), 1397–1404. https://doi.org/10.1111/ans.16615
Silva Bemos, W. A., & Ruiz Vinueza, V. I. (2022). Tratamiento conservador y tratamiento quirúrgico para apendicitis aguda no complicada en adultos: revisión bibliográfica. RECIMUNDO, 6(2), 34–46. https://doi.org/10.26820/recimundo/6.(2).abr.2022.34-46
Tlalpachicatl Cruz, N., Pérez López, C. G., & Pérez López, C. I. (2024). Aula invertida en educación superior: Análisis de un curso de métodos de investigación en Psicología Educativa. Revista Iberoamericana de Educación, 95(1), 161–177. https://rieoei.org/RIE/article/view/6268
Weledji, E. P., Zisuh, A. V., & Ngounou, E. (2023). Management of appendicitis: appendicectomy, antibiotic therapy, or both? Annals of medicine and surgery, 85(4), 897–901. https://doi.org/10.1097/MS9.0000000000000401
Yuan, J., Li, W., Qiu, E., Han, S., & Li, Z. (2021). Metagenomic NGS optimizes the use of antibiotics in appendicitis patients: bacterial culture is not suitable as the only guidance. American journal of translational research, 13(4), 3010–3021. https://pubmed.ncbi.nlm.nih.gov/34017469/
Zhang, C., Tian, L., & Chu, H. (2023). Usage frequency and application variety of research methods in library and information science: Continuous investigation from 1991 to 2021. Information Processing & Management, 60(6), 4–8. https://doi.org/10.1016/j.ipm.2023.103503
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Adriano Mauricio Segura-Riera, Jonathan Ismael Segura-Riera, Andrea Mishell Velastegui-Guerrero (Autor/a)
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Authors who publish in Revista Metropolitana de Ciencias Aplicadas (REMCA), agree to the following terms:
1. Copyright
Authors retain unrestricted copyright to their work. Authors grant the journal the right of first publication. To this end, they assign the journal non-exclusive exploitation rights (reproduction, distribution, public communication, and transformation). Authors may enter into additional agreements for the non-exclusive distribution of the version of the work published in the journal, provided that acknowledgment of its initial publication in this journal is given.
© The authors.
2. License
The articles are published in the journal under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License (CC BY-NC-SA 4.0). The terms can be found at: https://creativecommons.org/licenses/by-nc-sa/4.0/deed.en
This license allows:
- Sharing: Copying and redistributing the material in any medium or format.
- Adapting: Remixing, transforming, and building upon the material.
Under the following terms:
- Attribution: You must give appropriate credit, provide a link to the license, and indicate if any changes were made. You may do this in any reasonable manner, but not in any way that suggests the licensor endorses or sponsors your use.
- NonCommercial: You may not use the material for commercial purposes.
- ShareAlike: If you remix, transform, or build upon the material, you must distribute your creation under the same license as the original work.
There are no additional restrictions. You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
