Appendectomy in Germany—an analysis of a nationwide survey 2011/2012

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• 作者：Dirk Rolf Bulian (1)
  Jürgen Knuth (1)
  Axel Sauerwald (2)
  Michael Alfred Str?hlein (1)
  Rolf Lefering (3)
  J?rg Ansorg (4)
  Markus Maria Heiss (1)
  
• 关键词：Survey ; Appendectomy/methods ; Appendicitis/surgery ; Laparoscopy/methods ; Laparoscopic ; Open ; Single port ; NOTES ; Surgical technique
• 刊名：International Journal of Colorectal Disease
• 出版年：2013
• 出版时间：January 2013
• 年：2013
• 卷：28
• 期：1
• 页码：127-138
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• 作者单位：Dirk Rolf Bulian (1)
  Jürgen Knuth (1)
  Axel Sauerwald (2)
  Michael Alfred Str?hlein (1)
  Rolf Lefering (3)
  J?rg Ansorg (4)
  Markus Maria Heiss (1)
  
  1. Department of Abdominal, Vascular and Transplant Surgery, Cologne-Merheim Medical Center, Witten/Herdecke University, Ostmerheimer Strasse 200, 51109, Cologne, Germany
  2. Department for Obstetrics and Gynaecology Holweide, Neufelder Str 32, 51067, Cologne, Germany
  3. Institute for Research in Operative Medicine, Witten/Herdecke University, Ostmerheimer Strasse 200, 51109, Cologne, Germany
  4. Professional Association of German Surgeons (BDC), Berlin, Germany
  
• ISSN：1432-1262

文摘

Introduction Although appendectomies are frequently performed and new procedural techniques have emerged, no nationwide analysis exists after the cessation of the German quality control in 2004. Methods One thousand eight hundred seventy surgical hospitals in Germany were asked to answer questions anonymously concerning the size of the department, applied procedural techniques, various technical details, as well as the approach to the intraoperative finding of an inconspicuous appendix. Results We received 643 questionnaires (34.4?%) for evaluation. Almost all hospitals (95.5?%) offer laparoscopic appendectomy (LA), 15.4?% offer single-port (SPA), and 2.2?% (hybrid-) NOTES technique (NA). LA is the standard procedure in 85.2?% of male and in 89.1?% for female patients. In an open procedure (OA), the appendix and mesoappendix are mostly ligated (93.8 and 91.5?%). A Veress needle and open access are employed equally for LA. In 66.6?% of LA, the appendix is divided using an Endo-GIA, the mesoappendix in 45.5?% with bipolar coagulation. Almost half of the hospitals routinely flush the site in OA and LA. In open surgery with an inconspicuous appendix but a pathological finding elsewhere in the abdomen, it is resected “en principe-in 64.7?% and in the absence of any pathological finding in 91.2?%. For laparoscopic procedures, the numbers are 54.8 and 88.4?%. Conclusions Most German hospitals perform appendectomies laparoscopically regardless of patients-gender. Usage of an Endo-GIA is widely established. SPA has not gained much acceptance, nor is NA widely used yet. In the absence of any pathological findings in particular, the macroscopically inconspicuous appendix results in an appendectomy “en principe-in most German hospitals.