1
|
Dong W, Qiu M, Ma X, Zhou S, Chen H, Chu H, Zhong Y. Placement of a drainage tube in the ileac lumen following laparoscopic appendectomy: A case report and literature review. Medicine (Baltimore) 2024; 103:e38405. [PMID: 38847709 PMCID: PMC11155555 DOI: 10.1097/md.0000000000038405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 05/09/2024] [Indexed: 06/10/2024] Open
Abstract
RATIONALE Ileal perforation caused by the insertion of a drainage tube is a rare complication. Hence, the utilization of surgical drains in abdominal surgery remains controversial. At present, there is a trend to reduce the utilization of drains in abdominal surgery, although certain situations may necessitate their application. PATIENT CONCERNS A 25-year-old Chinese woman presented with a history of right lower abdominal pain persisting for 10 days. Imaging examinations, including abdominal computed tomography and ultrasound, identified low-density lesions measuring 10 × 8 × 8cm3 in the right lower abdomen, which are consistent with perforated appendicitis complicated by a peri-appendiceal abscess. A laparoscopic appendectomy was carried out. On the 5th postoperative day, the drainage fluid changed to a grass-green color (80mL). Imaging with retrograde contrast through the drainage tube revealed that the 26 Fr silicon rubber drainage tube tip was positioned 50cm away from the ileocecal junction within the ileum. Both the ileal and ileocecal regions appeared well-developed. INTERVENTION AND OUTCOMES Oral intake was suspended, and the patient received antacids, somatostatin, antibiotics, and total parenteral nutrition. On the 19th postoperative day, a follow-up imaging procedure using retrograde contrast through the drainage tube indicated that the tube tip was sealed. The treatment concluded on day 33 postoperatively, and the patient was discharged. DISCUSSION AND CONCLUSION Ileal perforation due to an abdominal drainage tube following laparoscopic appendectomy constitutes a rare but serious complication. However, due to the adhesion and inflammatory changes around the abscess, laparoscopic dissection becomes a challenging and risky process, and the surgical skills and experiences are particularly important. Removing the abdominal drainage tube promptly based on the characteristics of the drainage fluid is recommended. The findings provide valuable insights for surgeons navigating similar challenges.
Collapse
Affiliation(s)
- Wei Dong
- Department of General Surgery, Jiaozhou Branch of Shanghai East Hospital, Tongji University, Qingdao, China
| | - Meng Qiu
- Department of General Surgery, Jiaozhou Branch of Shanghai East Hospital, Tongji University, Qingdao, China
| | - Xuhui Ma
- Department of General Surgery, Jiaozhou Branch of Shanghai East Hospital, Tongji University, Qingdao, China
| | - Shunchang Zhou
- Department of General Surgery, Jiaozhou Branch of Shanghai East Hospital, Tongji University, Qingdao, China
| | - Hao Chen
- Department of General Surgery, Jiaozhou Branch of Shanghai East Hospital, Tongji University, Qingdao, China
| | - Haibo Chu
- Department of General Surgery, Jiaozhou Branch of Shanghai East Hospital, Tongji University, Qingdao, China
| | - Yuxu Zhong
- State Key Laboratory of Toxicology and Medical Countermeasures, Institute of Pharmacology and Toxicology, Beijing, China
| |
Collapse
|
2
|
Cappuccio M, Bianco P, Rotondo M, Spiezia S, D'Ambrosio M, Menegon Tasselli F, Guerra G, Avella P. Current use of artificial intelligence in the diagnosis and management of acute appendicitis. Minerva Surg 2024; 79:326-338. [PMID: 38477067 DOI: 10.23736/s2724-5691.23.10156-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2024]
Abstract
INTRODUCTION Acute appendicitis is a common and time-sensitive surgical emergency, requiring rapid and accurate diagnosis and management to prevent complications. Artificial intelligence (AI) has emerged as a transformative tool in healthcare, offering significant potential to improve the diagnosis and management of acute appendicitis. This review provides an overview of the evolving role of AI in the diagnosis and management of acute appendicitis, highlighting its benefits, challenges, and future perspectives. EVIDENCE ACQUISITION We performed a literature search on articles published from 2018 to September 2023. We included only original articles. EVIDENCE SYNTHESIS Overall, 121 studies were examined. We included 32 studies: 23 studies addressed the diagnosis, five the differentiation between complicated and uncomplicated appendicitis, and 4 studies the management of acute appendicitis. CONCLUSIONS AI is poised to revolutionize the diagnosis and management of acute appendicitis by improving accuracy, speed and consistency. It could potentially reduce healthcare costs. As AI technologies continue to evolve, further research and collaboration are needed to fully realize their potential in the diagnosis and management of acute appendicitis.
Collapse
Affiliation(s)
- Micaela Cappuccio
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Paolo Bianco
- Hepatobiliary and Pancreatic Surgery Unit, Pineta Grande Hospital, Castel Volturno, Caserta, Italy
| | - Marco Rotondo
- V. Tiberio Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy
| | - Salvatore Spiezia
- V. Tiberio Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy
| | - Marco D'Ambrosio
- V. Tiberio Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy
| | | | - Germano Guerra
- V. Tiberio Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy
| | - Pasquale Avella
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy -
- Hepatobiliary and Pancreatic Surgery Unit, Pineta Grande Hospital, Castel Volturno, Caserta, Italy
| |
Collapse
|
3
|
Chidiac C, Phan P, Rhee DS, Garcia AV. Access to Laparoscopic Pediatric Surgery: Do Ethnic and Racial Disparities Exist? J Surg Res 2024; 296:265-272. [PMID: 38295714 DOI: 10.1016/j.jss.2023.12.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 12/12/2023] [Accepted: 12/30/2023] [Indexed: 03/19/2024]
Abstract
INTRODUCTION Disparate access to laparoscopic surgery may contribute to poorer health outcomes among racial and ethnic minorities, especially among children. We investigated whether racial and ethnic disparities in laparoscopic procedures existed among four common surgical operations in the pediatric population in the United States. METHODS Using the American College of Surgeons National Surgical Quality Improvement Program-Pediatrics, we conducted a retrospective review of pediatric patients, aged less than 18 y old, undergoing appendectomy, fundoplication, cholecystectomy, and colectomy from 2012 to 2021. To compare the surgical approach (laparoscopy or open), a propensity score matching algorithm was used to compare laparoscopic and open procedures between non-Hispanic Black with non-Hispanic White children and Hispanic with non-Hispanic White children. RESULTS 143,205, 9,907, 4,581, and 26,064 children underwent appendectomy, fundoplication, colectomy, and cholecystectomy, respectively. After propensity score matching, non-Hispanic Black children undergoing appendectomy were found to be treated laparoscopically less than non-Hispanic White children (93.5% versus 94.4%, P = 0.007). With fundoplication, Hispanic children were more likely to be treated laparoscopically than White ones (86.7% versus 80.9%, P < 0.0001). There were no statistically significant differences between Black or Hispanic children and White children in rates of laparoscopy for other procedures. CONCLUSIONS Though some racial and ethnic disparities exist with appendectomies and fundoplications, there is limited evidence to indicate that widespread inequities among common laparoscopic procedures exist in the pediatric population.
Collapse
Affiliation(s)
- Charbel Chidiac
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Paul Phan
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Daniel S Rhee
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Alejandro V Garcia
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
| |
Collapse
|
4
|
Rolle U, Bechstein WO, Fahlenbrach C, Heller G, Meyer HJ, Schuler E, Stier A, Waibel B, Jeschke E, Günster C, Maneck M. The Outcome of Laparoscopic Versus Open Appendectomy in Childhood. DEUTSCHES ARZTEBLATT INTERNATIONAL 2024; 121:39-44. [PMID: 37967286 PMCID: PMC10979443 DOI: 10.3238/arztebl.m2023.0234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 10/23/2023] [Accepted: 10/23/2023] [Indexed: 11/17/2023]
Abstract
BACKGROUND Appendectomy in children is performed either lapa - roscopically (LA) or by open surgery (OA). We studied whether, and how, the outcome is affected by the technique used and by the intraoperative conversion of LA to OA. METHODS We analyzed routine data from children and adolescents in three age groups (1-5 years, 6-12 years, and 13-17 years) who were insured by the AOK statutory health insurance carrier in Germany and who underwent appendectomy in the period 2017-2019. General surgical complications and reoperations within 90 days were assessed with relevant indicators. Associations between the surgical technique and these indicators were studied with logistic regression. RESULTS Of the 21 541 patients included in the study, general surgical complications were observed in 2.1% and reoperations in 1.8% overall. Broken down by age group, the corresponding figures were 5.4% and 4.4% (age 1 to 5), 2.5% and 1.8% (age 6 to 12), and 1.5% and 1.6% (age 13 to 17). The main risk factors for complications and reoperations were acute complicated appendicitis and conversion from LA to OA. Regression analysis revealed similar outcomes with OA compared to LA in the 1-to-5 age group, (odds ratios and 95% confidence intervals: 1.1 [0.6; 2.1] for general surgical complications and 1.5 [0.8; 2.7] for reoperations), but worse outcomes with OA in the other two age groups (age 6 to 12: 1.9 [1.2; 2.9] and 2.1 [1.5; 2.9]; age 13 to 17: 1.7 [1.0; 2.9] and 2.2 [1.4; 3.6]). When conversions were assigned to the LA group, the odds ratio (OA compared to LA) for reoperation across all age groups was 3.5 [2.8; 4.4] in patients with acute uncomplicated appendicitis and 4.2 [3.4; 5.3] in patients with complicated appendicitis. Complicated appendicitis also increased the rate of general surgical complications and the length of stay in hospital. CONCLUSION Among children in the two older age groups, LA was followed by fewer general surgical complications and reoperations than OA. These differences were less pronounced when conversions were counted as belonging to the LA group. Children aged 1-5 appear to benefit the least from the lapa - roscopic technique.
Collapse
Affiliation(s)
- Udo Rolle
- Department of Pediatric Surgery and Pediatric Urology, University Hospital Frankfurt/Main, Frankfurt/Main, Germany
| | - Wolf O. Bechstein
- Department of General, Visceral, Transplantation and Thoracic Surgery, University Hospital Frankfurt/Main, Frankfurt/Main, Germany
| | | | - Günther Heller
- Institute for Quality Assurance and Transparency in Healthcare (IQTIG), Berlin, Germany
| | | | - Ekkehard Schuler
- Helios Kliniken, Division of Quality Management, Berlin, Germany
| | - Albrecht Stier
- Department of General and Visceral Surgery, HELIOS Hospital Erfurt, Erfurt, Germany
| | - Beate Waibel
- Medical Service of the Health Insurance Fund Baden-Württemberg, Freiburg, Germany
| | | | | | | |
Collapse
|
5
|
Neville JJ, Aldeiri B. Drain placement in paediatric complicated appendicitis: a systematic review and meta-analysis. Pediatr Surg Int 2023; 39:171. [PMID: 37031267 DOI: 10.1007/s00383-023-05457-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/03/2023] [Indexed: 04/10/2023]
Abstract
Children undergoing appendicectomy for complicated appendicitis are at an increased risk of post-operative morbidity. Placement of an intra-peritoneal drain to prevent post-operative complications is controversial. We aimed to assess the efficacy of prophylactic drain placement to prevent complications in children with complicated appendicitis. A systematic review was performed in accordance with PRISMA guidelines. Cochrane, MEDLINE and Web of Science databases were searched from inception to November 2022 for studies directly comparing drain placement to no drain placement in children ≤ 18 years of age undergoing operative treatment of complicated appendicitis. A total of 5108 children with complicated appendicitis were included from 16 studies; 2231 (44%) received a drain. Placement of a drain associated with a significantly increased risk of intra-peritoneal abscess formation (odds ratio [OR] 1.61, 95% confidence interval [CI] 1.16-2.24, p = 0.004) but there was no significant difference in wound infection rate (OR 1.46, 95% CI 0.74-2.88, p = 0.28). Length of stay was significantly longer in the drain group (mean difference 2.02 days, 95% CI 1.14-2.90, p < 0.001). Although the quality and certainty of the available evidence is low, prophylactic drain placement does not prevent intra-peritoneal abscess following appendicectomy in children with complicated appendicitis.
Collapse
Affiliation(s)
- J J Neville
- Department of Paediatric Surgery, University Surgery Unit, University Hospitals Southampton, Southampton, UK.
| | - B Aldeiri
- Department of Paediatric Surgery, Chelsea Children's Hospital, Chelsea and Westminster Hospital Trust, London, UK
| |
Collapse
|
6
|
Li W, Lin Q, Sun X. Effect of transumbilical single-port laparoscopic appendectomy on postoperative bowel function in pediatric complex appendicitis. Minerva Gastroenterol (Torino) 2023; 69:160-162. [PMID: 36269066 DOI: 10.23736/s2724-5985.22.03170-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Wei Li
- Anaesthetic Operating Room, Yantai Hospital of Traditional Chinese Medicine, Yantai, China
| | - Qiling Lin
- Department of Medical Cosmetology, Yantai Hospital of Traditional Chinese Medicine, Yantai, China
| | - Xiufang Sun
- Pediatric Health Care Clinic, Yantai Hospital of Traditional Chinese Medicine, Yantai, China -
| |
Collapse
|
7
|
Energy Devices for Clipless-Sutureless Laparoscopic Appendectomy: A Systematic Review and Meta-Analysis on Utility and Safety. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58111535. [PMID: 36363491 PMCID: PMC9694935 DOI: 10.3390/medicina58111535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 10/23/2022] [Accepted: 10/25/2022] [Indexed: 11/06/2022]
Abstract
Background and Objectives: While laparoscopic appendectomy is standardized, techniques for appendiceal stump closure and mesoappendix division remain variable. Novel vessel sealing techniques are increasingly utilized ubiquitously. We sought to systematically summarize all relevant data and to define the current evidence on the safety and utility of energy devices for clipless−sutureless laparoscopic appendectomy in this systematic review and meta-analysis. Materials and Methods: This review was conducted following the PRISMA guidelines. PubMed, Embase, Scopus, and Web of Science were systematically searched. Inclusion criteria included studies with laparoscopic appendectomy for appendicitis. The intervention included patients undergoing division of mesoappendix and/or securing of the appendicular base using diathermy (Monopolar or Bipolar or LigaSure Sealing Device) or Harmonic Scalpel (Group A) compared to patients undergoing division of mesoappendix and/or securing of the appendicular base using endoclip or Hem-o-lok or ligature (Group B). The methodological quality of the included studies was assessed using the Downs and Black scale. The outcomes of surgical site infection (SSI) or intra-abdominal collection, postoperative ileus, average operative duration, and length of hospital stay (LHS) were compared. Results: Six comparative studies were included; three were retrospective, two were prospective, and one was ambispective. Meta-analysis revealed a shorter operative duration in Group A with respect to appendicular base ligation (MD −12.34, 95% CI −16.57 to −8.11, p < 0.00001) and mesoappendix division (MD −8.06, 95% CI −14.03 to −2.09, p = 0.008). The pooled risk ratios showed no difference in SSI between groups. Additionally, no difference was observed in LHS. The risk of postoperative ileus was higher in group B regarding mesoappendix division (RR 0.56, 95% CI 0.34 to 0.93, p = 0.02), but no difference was found concerning appendicular base ligation. The included studies showed a moderate-to-high risk of bias. Conclusions: Clipless−sutureless laparoscopic appendectomy is safe and fast. Postoperative ileus seems less common with energy devices for mesoappendix division. However, the studies included have a moderate-to-high risk of bias. Further studies addressing the individual devices with surgeons of similar levels are needed.
Collapse
|
8
|
Jianyong Z, Yanruo H. Response to: Laparoscopic versus open appendicectomy for complicated appendicitis in children: A systematic review and meta-analysis. J Pediatr Surg 2022; 57:248. [PMID: 35599047 DOI: 10.1016/j.jpedsurg.2022.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 04/08/2022] [Indexed: 10/18/2022]
Affiliation(s)
- Zhang Jianyong
- Department of General Surgery, the Affiliated Hospital of Guizhou Medical University, No. 28 Guiyi Street, Yunyan District, 550004, Guiyang, China
| | - Huang Yanruo
- Department of Anesthesiology, the Affiliated Hospital of Guizhou Medical University, No. 28 Guiyi Street, Yunyan District, 550004, Guiyang, China.
| |
Collapse
|
9
|
Theodorou CM, Lee SY, Lawrence Y, Saadai P, Hirose S, Brown EG. The Utility of Discharge Antibiotics in Pediatric Perforated Appendicitis Without Leukocytosis. J Surg Res 2022; 275:48-55. [PMID: 35219251 PMCID: PMC10032146 DOI: 10.1016/j.jss.2022.01.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 12/14/2021] [Accepted: 01/26/2022] [Indexed: 01/13/2023]
Abstract
INTRODUCTION Optimal management of pediatric perforated appendicitis remains a topic of active investigation. Our institutional clinical practice guidelines (CPGs) were modified to discontinue antibiotics on discharge for patients with normal white blood cell count (WBC) without left shift. We hypothesized that patients would receive fewer antibiotics without increased complications. METHODS Patients <18 y old with perforated appendicitis who underwent laparoscopic appendectomy between November 1, 2016 and May 31, 2021 at a tertiary care children's hospital were included. Primary outcome was adverse events: postdischarge surgical site infection (SSI), 30-day emergency department (ED) visits, or readmissions. Outcomes were compared before and after CPG modification. Multivariable regression was performed to identify factors associated with SSI. RESULTS There were 113 patients pre- and 97 patients post-CPG modification. 23.1% of patients in the pre-cohort had an elevated discharge WBC or left shift compared to 18.9% of patients in the post-cohort (P = 0.48). Significantly fewer patients were prescribed antibiotics on discharge in the post-cohort (70.8% pre versus 14.4% post, P < 0.0001) and for fewer days (2 pre versus 0 post, P < 0.0001). Total antibiotic days decreased significantly (6.1 pre versus 4.6 post, P < 0.0001). There was an increase in postdischarge SSIs on univariate analysis (1.8% pre versus 9.3% post, P = 0.03), ED visits (9.7% pre versus 19.6% post, P = 0.04), and readmissions (5.3% pre versus 11.3% post, P = 0.13). On multivariable analysis, being in the post-cohort was not significantly associated with post-discharge SSIs after adjusting for sex, symptom duration, initial WBC, and discharge antibiotic duration (OR 0.25, 95% CI 0.04-1.4, P = 0.11). CONCLUSIONS Modification of a pediatric perforated appendicitis clinical practice guideline to discontinue antibiotics on discharge with a normal WBC without left shift was effective in decreasing antibiotic duration. This was associated with an increase in SSIs on univariate analysis, which did not persist on multivariable analysis and requires further investigation.
Collapse
Affiliation(s)
- Christina M Theodorou
- Department of Pediatric General, Thoracic, and Fetal Surgery, University of California Davis Medical Center, Sacramento, California.
| | - Su Yeon Lee
- Department of Pediatric General, Thoracic, and Fetal Surgery, University of California Davis Medical Center, Sacramento, California
| | - Yemi Lawrence
- Department of Pediatric General, Thoracic, and Fetal Surgery, University of California Davis Medical Center, Sacramento, California
| | - Payam Saadai
- Department of Pediatric General, Thoracic, and Fetal Surgery, University of California Davis Medical Center, Sacramento, California
| | - Shinjiro Hirose
- Department of Pediatric General, Thoracic, and Fetal Surgery, University of California Davis Medical Center, Sacramento, California
| | - Erin G Brown
- Department of Pediatric General, Thoracic, and Fetal Surgery, University of California Davis Medical Center, Sacramento, California
| |
Collapse
|
10
|
Antic J, Jokic R, Bukarica S, Lukic I. Postoperative recovery assessment after appendectomy in children - laparoscopic versus open technique. SRP ARK CELOK LEK 2022. [DOI: 10.2298/sarh210710015a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Introduction/Objective. Surgery is a ?gold standard? in treating the acute
appendicitis in pediatric patients. The aim of the study was to determine
the effect of open and laparoscopic appendectomy on postoperative recovery,
return to everyday activities and quality of life in patients operated for
the acute appendicitis. Methods. This prospective study was performed at
the Institute for Children and Youth Healthcare of Vojvodina, during a
period of ten months. This study was approved by Ethic committee of the
Institute. All patients treated for the acute appendicitis by surgery were
divided into two basic groups: open or laparoscopic appendectomy and into
three subgroups, depending on the degree of appendicitis. We analyzed length
of surgery, oral intake, establishing peristalsis, hospital stay, return to
everyday activities and quality of life after surgery. Results.
Laparoscopic technique was performed in 60 patients (48%), and the open
method in 65 (52%). In laparoscopically treated patients (66.7%),
peristalsis occurred earlier (p < 0.001), length of hospital stay was
shorter (5.95 ? 1.21 days) (Z = -3.054; p = 0.002), the total score of daily
activities showed a statistically significantly better score (Z = -7.667; p
= 0.000), and they achieved a high level of quality of life significantly
earlier (t = 2.773; p = 0.007). Conclusion. The advantage of minimally
invasive surgery in the treatment of acute appendicitis in children is
reflected in the faster re-establishment of every day functioning, faster
recovery, and a good quality of life.
Collapse
Affiliation(s)
- Jelena Antic
- University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia + Institute for Child and Youth Health Care of Vojvodina, Clinic of Pediatric Surgery, Novi Sad, Serbia
| | - Radoica Jokic
- University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia + Institute for Child and Youth Health Care of Vojvodina, Clinic of Pediatric Surgery, Novi Sad, Serbia
| | - Svetlana Bukarica
- University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia + Institute for Child and Youth Health Care of Vojvodina, Clinic of Pediatric Surgery, Novi Sad, Serbia
| | - Ivana Lukic
- University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia + Institute for Child and Youth Health Care of Vojvodina, Clinic of Pediatric Surgery, Novi Sad, Serbia
| |
Collapse
|
11
|
Rodriguez-Gutiérrez M, Diaz-Vallejo J, Bastidas-Acosta J, Lozada-Martinez I, Diaz-Rivera M. A comment on "laparoscopic versus open appendicectomy for complicated appendicitis in children: A systematic review and meta-analysis". J Pediatr Surg 2022; 57:175. [PMID: 34509282 DOI: 10.1016/j.jpedsurg.2021.08.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 08/12/2021] [Indexed: 11/24/2022]
Affiliation(s)
- Maria Rodriguez-Gutiérrez
- Future Surgeons Chapter, Colombian Surgery Association Bogotá, Calle 100 #14-63 Of.502, Bogotá, Colombia.
| | | | | | - Ivan Lozada-Martinez
- Medical and Surgical Research Center, School of Medicine, University of Cartagena, Cartagena, Colombia
| | - Maria Diaz-Rivera
- Facultad de Medicina, Fundación Universitaria Autónoma de las Améicas, Pereira, Colombia
| |
Collapse
|