Discordance of the pediatric surgeon's intraoperative assessment of pediatric appendicitis with the pathologists report

Journal of Pediatric Surgery
David BlissMark Silen

Abstract

The nature and duration of postoperative treatment in children with appendicitis is largely defined by the surgeon's intraoperative assessment of the degree of disease. Therefore, misclassification of patients could result in either inadequate or excessive duration of treatment. During the execution of an institutional review board-approved multicenter, randomized, prospective, single-blinded trial of laparoscopic versus open appendectomy in children, we tracked the attending pediatric surgeon's determination of the degree of appendicitis and compared it to the pathologists report. Postoperative care was determined, per protocol, by the surgeon's intraoperative classification. "Interval" appendectomies were excluded from the analysis. Statistical significance was analyzed using chi(2) analyses. A total of 133 patients were randomized into the open group, whereas 122 randomized to laparoscopy during the first 2 years of the study. The attending pediatric surgeons and pathologists were concordant in the determination of acute appendicitis in 90% of open patients and 93% of laparoscopic patients (P = not significant). When children were classified by the attending surgeon as having complicated appendicitis (gangrenous or ruptured)...Continue Reading

References

Jun 1, 1987·The Australian and New Zealand Journal of Surgery·J E Wright, M Rowley
Apr 5, 2008·International Journal of Surgical Pathology·John K RobertsJanek Dmitrewski

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Citations

Jul 27, 2011·Italian Journal of Pediatrics·Stefanos GardikisGeorge Vaos
Aug 26, 2014·Journal of Pediatric Surgery·Hanna AlemayehuDaniel J Ostlie
Jul 26, 2014·International Journal of Colorectal Disease·Charles C van RossemAnna A W van Geloven
Jun 11, 2016·Pediatric Radiology·Morgan E TelesmanichR Paul Guillerman
Jul 15, 2017·Annals of Surgical Treatment and Research·Jinbeom ChoJunhyun Lee
Aug 15, 2019·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Matthijs D M BolmersUNKNOWN Snapshot Appendicitis Collaborative Study group
Nov 30, 2018·The Cochrane Database of Systematic Reviews·Thomas JaschinskiStefan Sauerland
Oct 15, 2018·Pediatric Surgery International·Katherine J BaxterMehul V Raval
May 9, 2021·The Journal of Surgical Research·Khaled Abdul JawadUNKNOWN EAST Appendicitis Research Group
May 14, 2011·Current Opinion in Pediatrics

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