Objective: To evaluate the effectiveness of a new set of surgical criteria incorporating multidetector computed tomography (MDCT) for suspected acute appendicitis in reducing the percentage of negative appendectomies and surgical complications. Methods: The patients were divided into two groups: Group A, comprising patients who were admitted between 2008 and 2013 and treated based on the new criteria; and Group B, comprising patients who were admitted between 2003 and 2007 and treated based on the standard criteria. Sensitivity, specificity, and positive and negative predictive values were calculated. Results: Out of 1021 patients, 533 (274 males, 259 females) belonged to Group A and 488 (263 males, 225 females) to Group B. Surgical procedures were performed in 46.0% (245 cases) of patients in Group A and 64.3% (314 cases) in Group B (P>0.001). The rate of conservative treatment was significantly higher in Group A. The overall rate of catarrhal appendicitis based on histopathological findings was 6.9% (17 cases) in Group A and 15.0% (47 cases) in Group B (P>0.003). The overall rate of surgical complications was significantly higher in Group B, being observed in 14.6% (46 cases) in this group, but only 8.2% (20 cases) of patients in Group A (P>0.02). No statistically significant difference was observed in rate of conversion to surgery after conservative therapy or recurrence between the two groups. Conclusion: Our new surgical criteria incorporating MDCT are effective in reducing the incidence of negative appendectomies and surgical complications.
Diagnostic performance of surgical criteria incorporating MDCT for suspected acute appendicitis
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Mitsugu Kochi, Hiroshi Suda, Masashi Fujii, Ken Hagiwara, Hiroko Shimizu, Megumu Watanabe, Yoritaka Matsuno, Takaharu Kawai, Renpei Yagi, Tadatoshi Takayama; Diagnostic performance of surgical criteria incorporating MDCT for suspected acute appendicitis. Int Surg doi: https://doi.org/10.9738/INTSURG-D-17-00102.1
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