| Abstract | Cilj istraţivanja: Cilj ovog retrospektivnog presječnog istraţivanja bio je opravdati izvoĎenje incidentalne apendektomije jer smatramo da je prevalencija neoplazmi crvuljka veća u incidentalnoj apendektomiji nego u apedektomiji učinjenoj zbog akutnog apendicitisa.
Ispitanici i metode: Pregledana je baza nalaza patohistološke dijagnostike (PHD) Klinike za kirurgiju, KBC-a Split u razdoblju od 1. siječnja 2017. do 31. prosinca 2021. Promatrani su samo PHD nalazi koji su opisivali patologiju debelog crijeva ili crvuljka. Pregledano je ukupno 2832 nalaza koji su podijeljeni u skupinu apendektomija uraĎenih u hitnoj sluţbi zbog sumnje na apendicitis (AA) i skupinu incidentalnih apendektomija (IA). Primarna mjera ishoda je prevalencija neoplazmi crvuljka izračunata iz patohistoloških uzoraka IA koja je usporeĎena s prevalencijom neoplazmi crvuljka AA iz popratnih patohistoloških uzoraka. Hipoteze smo potvrdili statističkim testom (engl. comparison of proportions by Chi-square test). Rezultati: Skupine se nisu razlikovale u spolnoj raspodjeli, ali je AA imala statistički značajno manji medijan dobi bolesnika u odnosu na skupinu IA (40 naspram 68 godina; P < 0,001). Patohistološka dijagnostika pokazala je da je u skupini AA bilo 84,5% akutnih apendicitisa, 11,1% normalnih nalaza apendiksa, 3,2% apendicealnih tumora i 1,2% ostale patologije. Skupina IA je imala 89,5% normalnih nalaza apendiksa, 7,2% apendicealnih tumora i 0,5% ostale patologije. Učestalost neoplazmi crvuljka u skupini IA (7,2%) bila je statistički značajno veća nego u skupini AA (3,2%). Razlika je bila 4,0% (Hi-kvadrat; 95%CI: 2,2 - 5,8; P < 0,001). Zaključci: Učestalost neoplazmi u PHD nalazima IA jest značajno veća nego u PHD nalazima kod AA. Potreban broj incidentalnih apendektomija sa svrhom da se prevenira pojava jedne neoplazme crvuljka pri lijevoj hemikolektomiji jest 25. U populaciji starijoj od 60 godina, stopa kompliciranog apendicitisa bila je statistički značajno veća u odnosu na mlaĎe bolesnike. |
| Abstract (english) | Objectives: The aim of this retrospective cross-sectional study was to justify the performance of incidental appendectomy because we believe that the prevalence of neoplasms of the appendix is higher in incidental appendectomy than in appendectomy performed due to acute appendicitis. Patients and methods: The database of pathohistological diagnosis (PHD) findings of the Clinic for Surgery, University Hospital of Split was reviewed in the period from January 1, 2017 to December 31, 2021. Only PHD findings describing the pathology of the colon and appendix were observed. A total of 2832 findings were reviewed which were divided into the group of appendectomies performed in the emergency department due to suspected appendicitis (AA) and the group of incidental appendectomies (IA). The primary outcome measure is the prevalence of appendix neoplasms calculated from IA PHD samples, which was compared to the prevalence of appendix AA neoplasms from accompanying PHD samples. Results: There was no difference in gender distribution between these two groups, but AA had a statistically significantly lower median patient age compared to the group IA (40 vs. 68 years; P < 0.001). PHD samples showed that in the AA group there were 84.5% acute appendicitis, 11.1% normal appendiceal findings, 3.2% appendiceal neoplasms and 1.2% other pathologies. The group IA had 89.5% normal findings of the appendix, 7.2% appendiceal neoplasms and 0.5% other pathology. The frequency of appendix neoplasms in group IA (7.2%) was statistically significantly higher than in the group AA (3.2%). Conclusion: The frequency of neoplasms in PHD samples of IA is significantly higher than in PHD samples of AA. The needed number of incidental appendectomies to prevent one appendiceal neoplasm is (NNT) 25. In patients older than 60 years, the rate of complicated appendicitis was significantly higher compared to younger patients. |
