| Abstract | Ciljevi: Ciljevi ovog istraživanja bili su utvrditi incidenciju negativne apendektomije u Klinici za dječju kirurgiju KBC-a Split i analizirati demografske i kliničke podatke ispitanika čiji je patohistološki nalaz apendektomije bio negativan.
Ispitanici i metode: Provedeno je monocentrično retrospektivno istraživanje. Iz operacijskih protokola izdvojili smo ispitanike mlađe od 18 godina koji su podvrgnuti apendektomiji zbog sumnje na akutni apendicitis u vremenskom razdoblju od 1. siječnja 2012. do 31. prosinca 2021. godine. Pretražena je pismohrana patohistoloških nalaza da bi se izdvojili ispitanici čija je apendektomija bila negativna. Njihove povijesti bolesti proučene su u svrhu izdvajanja sljedećih parametara: dob, spol, indeks tjelesne težine, laboratorijski, klinički i nalaz ultrazvučne pretrage abdomena.
Rezultati: Ukupno je apendektomirano 1646 djece zbog sumnje na apendicitis. Desetogodišnja incidencija negativnih apendektomija iznosila je 14,82% (n=244/1646). Medijan dobi iznosio je 12 godina (IQR 9, 15). Zabilježen je neznatno veći broj djevojčica, njih 128 (52,46%), ali značajno najveći broj negativnih apendektomija nalazio se u skupini djevojčica od 10 do 15 godina (P<0,0001). Medijan indeksa tjelesne težine bio je u kategoriji normalne uhranjenosti. Medijan vrijednosti leukocita bio je urednih referentnih vrijednosti, 10,43 x109/L, dok su medijani neutrofila i CRP-a bili u povišenim vrijednostima iznosa 75,9% i 11 mg/L. Alvarado rezultat bio je medijana 6 (IQR 4; 7,5), a AIR rezultat medijana 5 (IQR 4; 7). Napravljeno je ukupno 84 (34,43%) ultrazvučnih pretraga od kojih je 47 (55,95%) bilo negativno. Porast broja ultrazvučnih pretraga iznosio je 49,57%. Utvrđena je značajna povezanost između broja negativnih apendektomija i godišnjeg doba (P=0,042). Broj patohistoloških nalaza crvuljka bez patološkog supstrata iznosio je 205 (12,45%).
Zaključci: Ukupna incidencija negativnih apendektomija u našoj ustanovi iznosila je 14,82% te ne pokazuje tendenciju pada kroz ispitivano razdoblje. Većina negativnih apendektomija bila je u djece starije od 9 godina života, među kojima najčešće u djevojčica dobi od 10 do 15 godina. Povećanje upotrebe pomoćnih dijagnostičkih metoda moglo bi utjecati na smanjenje incidencije negativnih apendektomija u djece u budućnosti. |
| Abstract (english) | Objectives: The aims of this study were to determine our unit's negative appendectomy rate and to analyse demographic and clinical data of subjects whose histopathology report was negative.
Subjects and methods: A single-centre retrospective study was performed. We singled out subjects younger than 18 years who underwent appendectomy for suspected acute appendicitis in time period from January 1st 2012. to December 31st 2021. Clinic's archive of histopathology reports was then searched for subjects with negative appendectomy. The case files of those subjects were studied thoroughly for reaserched parameters: age, sex, BMI, laboratory, clinical and ultrasound reports.
Results: A total of 1646 appendectomies for suspected appendicitis were done in children. Ten-year negative appendectomy rate was 14.82% (n=244/1646). The median age was 12 years (IQR (9, 15). Slightly larger number of girls was noted, 128 (52.46%), but significantly larger number of negative appendectomies were done in girls of age 10 to 15 years (P<0.0001). The BMI median was in the healthy weige range. Median of white blood cell count was within normal range, 10.43 x109/L, while medians of neutrophil count and CRP values were noted higher than normal range, 75.9% and 11 mg/L, respectively. Alvarado score had median 6 (IQR 4; 7,5) and AIR score median 5 (IQR 4; 7). The rate of children with negative appendectomy who underwent ultrasound was 34.43% (n=84/244), among which 47 (55,95%) were concluded negative reports. An increase in number of performed ultrasounds was 49.57%. Significant connection was established between the number of negative appendectomies and season period (P=0.042). There were 205 (12.45%) histopathology reports of normal appendix without any other primary or intraabdominal pathology present.
Conclusions: The total negative appendectomy rate in our institution was 14.82%. There was no significant decline during the researched time period. Majority of negative appendectomies was performed in children older than 9 years, among who most often in girls age 10 to 15 years. Increase in utilization of auxiliary diagnostic methods could affect the reduction of pediatric negative appendectomy rate. |
