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Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study

Title: Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study
Authors: Drake, TM
Camilleri-Brennan, J
Tabiri, S
Fergusson, SJ
Spence, R
Fitzgerald, JEF
Bhangu, A
Harrison, EM
Ademuyiwa, AO
Fergusson, S
Glasbey, JC
Khatri, C
Mohan, M
Nepogodiev, D
Soreide, K
Gobin, N
Freitas, AV
Hall, N
Kim, S-H
Negida, A
Jaffry, Z
Chapman, SJ
Arnaud, AP
Recinos, G
Manipal, CE
Amandito, R
Shawki, M
Hanrahan, M
Pata, F
Zilinskas, J
Roslani, AC
Goh, CC
Irwin, G
Shu, S
Luque, L
Shiwani, H
Altamimi, A
Alsaggaf, MU
Rayne, S
Jeyakumar, J
Cengiz, Y
Raptis, DA
Fermani, C
Balmaceda, R
Marta Modolo, M
Macdermid, E
Chenn, R
Yong, CO
Edye, M
Jarmin, M
D'amours, SK
Iyer, D
Youssef, D
Phillips, N
Brown, J
George, R
Koh, C
Warren, O
Hanley, I
Dickfos, M
Nawara, C
Oefner, D
Primavesi, F
Mitul, AR
Mahmud, K
Hussain, M
Hakim, H
Kumar, T
Oosterkamp, A
Assouto, PA
Lawani, I
Souaibou, YI
Tun, AK
Chong, CL
Devadasar, GH
Qadir, MRM
Aung, KP
Yeo, LS
Palomino Castillo, VD
Munhoz, MM
Moreira, G
Barros De Castro Segundo, LC
Khouri Ferreira, SA
Careta, MC
Kim, SB
De Sousa, AV
Lazzarini Cury, AD
Soares Miguel, GP
Carreiro De Freitas, AV
Silvestre, BP
Pinto Vianna, JG
Felipe, CO
Valente Laufer, LA
Altoe, F
Da Silva, LA
Pimenta, ML
Giuriato, TF
Bezerra Morais, PA
Luiz, JS
Araujo, R
Menegussi, J
Leal, M
Barroso de Lima, CV
Tatagiba, LS
Leal, A
Dos Santos, DV
Fraga, GP
Simoes, RL
Stock, S
Nigo, S
Kabba, J
Ngwa, TE
Brown, J
King, S
Zani, A
Azzie, G
Firdouse, M
Kushwaha, S
Agarwal, A
Bailey, K
Cameron, B
Livingston, M
Horobjowsky, A
Deckelbaum, DL
Razek, T
Marinkovic, B
Grasset, E
D'aguzan, N
Jimenez, J
Macchiavello, R
Zhang, Z
Guo, W
Oh, J
Zheng, F
Montes, I
Sierra, S
Mendez, M
Isabel Villegas, M
Mendoza Arango, MC
Mendoza, I
Naranjo Aristizabal, FA
Montoya Botero, JA
Quintero Riaza, VM
Restrepo, J
Morales, C
Cruz, H
Munera, A
Karlo, R
Domini, E
Mihanovic, J
Radic, M
Zamarin, K
Pezelj, N
Hache-Marliere, M
Batista Lemaire, S
Rivas, R
Khyrallh, A
Hassan, A
Shimy, G
Fahmy, MAB
Nabawi, A
Elfil, M
Ghoneem, M
Gohar, ME-SAM
Asal, M
Abdelkader, M
Gomah, M
Rashwan, H
Karkeet, M
Gomaa, A
Hasan, A
Elgebaly, A
Saleh, O
Fattah, AA
Gouda, A
Elshafay, AE
Gharib, A
Menshawy, A
Hanafy, M
Al-Mallah, A
Abdulgawad, M
Baheeg, M
Alhendy, M
AbdelFattah, I
Kenibar, A
Osman, O
Gemeah, M
Mohammed, A
Adel, A
Mohammed, A
Sayed, A
Abozaid, M
Kotb, AHE-B
Ata, AAA
Nasr, M
Alkammash, A
Saeed, M
Abd El Hamid, N
Attia, AM
Abd El Galeel, A
Elbanby, E
El-Dien, KS
Hantour, U
Alahmady, O
Mansour, B
Elkorashy, AM
Taha, EMS
Lasheen, KT
Elkolaly, SS
Abdel-Wahab, NYE
Abozyed, MAF
Adel, A
Saeed, AM
El Sayed, GS
Youssif, JH
Ahmed, SM
El-Shahat, NS
Khedr, AE-RH
Elsebaaye, AO
Elzayat, M
Abdelraheim, M
Elzayat, I
Warda, M
El Deen, KN
Elnemr, AE
Salah, O
Abbas, M
Rashad, M
Elzayyat, I
Hemeda, D
Tawfik, G
Salama, M
Khaled, H
Seisa, M
Elshaer, K
Hussein, A
Elkhadrawi, M
Afifi, AM
Ebrahim, OS
Metwally, MM
Elmelegy, R
Elsawahly, DME
Safa, H
Nofal, E
Elbermawy, M
Ghazy, AA
Samih, H
Abdelgelil, A
Abdelghany, S
El Kholy, A
Aboraya, M
Elkady, F
Salma, M
Samy, S
Fakher, R
Aboarab, A
Samir, A
Sakr, A
Haroun, A
Al-Aarag, AA-R
Elkholy, A
Elshanwany, S
Ghanem, E
Tammam, A
Hammad, AM
El Shoura, Y
El Ashal, G
Khairy, H
Antar, S
Mehrez, S
Abdelshafy, M
Hamad, MGM
Hosh, M
Abdallah, E
Magdy, B
Alzayat, T
Gamaly, E
Elfeki, H
Abouzahra, A
Elsheikh, S
Elgendy, FI
Abd El-Salam, F
Seifelnasr, O
Ammar, M
Eysa, A
Sadek, A
Toeema, AG
Nasr, A
Abuseif, M
Zidan, H
Barakat, SAE
Elsayed, N
Abd Elrasoul, Y
Elkelany, A
Ammar, MS
Mustafa, M-A
Hegazy, Y
Etman, M
Saad, S
Alrahawy, M
Raslan, A
Morsi, M
Rslan, A
Sabry, A
Elwakil, H
Shaker, H
Abd-Elrasoul, Y
El-Kashef, H
Shaalan, M
Tarek, A
Elwan, A
Nayel, AR
Seif, M
Emadeldin, D
Ghonaim, MA
Almallah, A
Fouad, A
Sayma, EA
Elbatahgy, A
El-Ma'doul, AS
Mosad, A
Tolba, H
Elsorogy, DEAA
Mostafa, HA
Omar, AA
Abd El Hameed, OS
Lasheen, A
Abd El Salam, Y
Morsi, A
Ismail, M
El-badawy, HA
Amer, MA
El-Hamouly, AS
Attallah, NA
Mosalum, O
Afandy, A
Mokhtar, A
Abouelnasr, A
Ayad, S
Shaker, R
Sakr, R
Shaker, R
Amreia, M
Elsobky, S
Mustafa, M
El Magd, AA
Marey, A
Hafez, AT
Zalabia, MF
Mohamed, MM
Fadel, A
Ahmed, EA
Ali, A
Alwafai, MG
Dwydar, A
Kharsa, S
Mamdouh, E
El-Sheemy, H
AlYoussef, I
Aly, AK
Aldalaq, A
Alnawam, E
Alkhabbaz, D
Saad, M
Hussein, S
Elazayem, AA
Meshref, A
Elashmawy, M
Mousa, M
Nashaat, A
Ghanem, S
Elsayed, ZM
Elwaey, A
Elkadsh, I
Darweesh, M
Mohameden, A
Hafez, M
Badr, A
Badwy, A
Abd El Slam, M
Elazoul, M
Al-Nahrawi, S
Eldamaty, L
Nada, F
Ameen, M
Hagar, A
Elsehimy, M
Aboraya, M
Dawoud, H
El Mesery, S
El Gendy, A
Abdelkareem, A
Marey, AS
Allam, M
Shehata, S
Abozeid, K
Elshobary, M
Fahiem, A
Sarsik, S
Hashish, A
Zidan, M
Hashish, M
Aql, S
Elhendawy, AOA
Husseini, M
Kasem, E
Gheith, A
Elfouly, Y
Soliman, AR
Ibrahim, Y
Elfouly, N
Fawzy, A
Hassan, A
Rashid, M
Elsherbiny, AS
Sieda, B
Badwi, NM
Mohammed, MMH
Mohamed, O
Habeeb, MA
Worku, M
Starr, N
Desta, S
Wondimu, S
Abebe, NS
Thomas, E
Asele, FA
Dabessa, D
Abebe, NS
Zerihun, AB
Mentula, P
Leppaniemi, A
Sallinen, V
Scalabre, A
Frade, F
Irtan, S
Graffeille, V
Gaignard, E
Alimi, Q
Graffieille, V
Abbo, O
Mouttalib, S
Bouali, O
Hervieux, E
Aigrain, Y
Botto, N
Faure, A
Fievet, L
Panait, N
Eyssartier, E
Schmitt, F
Podevin, G
Parent, V
Martin, A
Arnaud, AP
Muller, C
Bonnard, A
Peycelon, M
Abantanga, F
Boakye-Yiadom, K
Bukari, M
Owusu, F
Awuku-Asabre, J
Bray, LD
Lytras, D
Psarianos, K
Bamicha, A
Kefalidi, E
Gemenetzis, G
Dervenis, C
Gouvas, N
Agalianos, C
Kontos, M
Kouraklis, G
Karousos, D
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Mitroudis, N
Estupinian, S
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Arevalo Azmitia, JR
Ramarez Cabrera, CC
Guevara, R
Aguilera, M
Mendez, N
Azmitia Mendizabal, CA
Ramazzini, P
Contreras Urquizu, M
Tale, F
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Barrios, E
Marroquin Rodriguez, DE
Perez Velasquez, CI
Contreras Merida, SM
Regalado, F
Lopez, M
Siguantay, M
Lam, FY
Szeto, KJ-Y
Szeto, CCL
Li, WS
Li, KKK
Leung, MF
Mak, T
Ng, S
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Kumar, BS
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Kumar, S
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Lakshmi, HN
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Sutanto, EPR
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Al-Hameedi, HII
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Item Type: Journal Article
Abstract: Background Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. Methods This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. Results 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33–4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76–2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42–0.71, p < 0.001) and SSIs (OR 0.22, 95% CI 0.14–0.33, p < 0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11–0.44) and SSI (OR 0.21 95% CI 0.09–0.45). Conclusion A laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments.
Issue Date: 1-Aug-2018
Date of Acceptance: 12-Jan-2018
URI: http://hdl.handle.net/10044/1/64252
DOI: https://dx.doi.org/10.1007/s00464-018-6064-9
ISSN: 0930-2794
Publisher: Springer Verlag
Start Page: 3450
End Page: 3466
Journal / Book Title: Surgical Endoscopy
Volume: 32
Issue: 8
Copyright Statement: © The Author(s) 2018. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
Keywords: Science & Technology
Life Sciences & Biomedicine
Surgery
Appendicitis
Appendectomy
Global surgery
Laparoscopic
Operative standards
Postoperative care
Postoperative complications
Surgical site infection
SURGICAL CARE
SURGERY
APPENDECTOMY
DISEASE
BURDEN
HEALTH
GlobalSurg Collaborative
1103 Clinical Sciences
Publication Status: Published
Online Publication Date: 2018-04-05
Appears in Collections:Department of Surgery and Cancer