a Retrospective Observational Study Comparing Outcomes of Retrocaecal Appendicitis With Non-retrocaecal Appendicitis

Study Overview
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Brief Summary
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A retrospective observational study investigating whether retrocecal appendicitis associated with worse operative and postoperative outcomes than non-retrocecal appendicitis.

Detailed Description
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Acute appendicitis is the most common cause of acute abdomen requiring acute surgery. The prevalence of the retrocaecal position of the appendix varies significantly between studies from 14 to 36%. Appendectomy of a retrocecal appendix is generally considered to be more demanding procedure than appendectomy of appendices in other positions. The aim of this study is to investigate whether retrocaecal appendicitis is associated with a higher rate of perioperative complications and delayed diagnosis when compared with the other positions. A retrospective analysis of prospectively collected data of patients undergoing surgery for signs of acute appendicitis from January 2015 to April 2020 at the University Hospital Kralovske Vinohrady. Two groups of patients were be formed: the retrocaecal group and the non-retrocaecal group. The following data were recorded: sex, age, body mass index, length of hospital stay, abdominal drain placement, length of surgery, surgical approach (laparoscopic, open or converted), operative finding (normal appendix or catarrhal, phlegmonous, gangrenous, or perforated appendicitis), position of the appendix (retrocaecal or non-retrocaecal positions), histopathological findings (acute inflammation, chronic inflammation, appendiceal tumour or normal appendix), 30-day postoperative complications, 30-day postoperative mortality, symptoms (abdominal pain, nausea, vomiting, diarrhoea, body temperature above 37 degrees celsius, urological complaints and gynaecological complaints), duration of symptoms (from onset to surgery), serious comorbidities and diabetes mellitus.

Official Title
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Retrocaecal Appendicitis: Risk Factor for Perioperative Complications?

Conditions
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Appendicitis, Appendicitis Acute, Retrocecal Appendicitis

Intervention / Treatment
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* Procedure: Appendectomy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All patients undergoing surgery for signs of acute appendicitis at the department of surgery of the University Hospital Kralovske Vinohrady between January 2015 to April 2020 Exclusion Criteria: Patients under 18 years of age

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Retrocaecal group<br>Patients who underwent surgery for signs of acute appendicitis and had intraoperative finding of the appendix located in the retrocaecal position. | Procedure: Appendectomy<br>* Surgical procedure for removal of the appendix<br>|
| Non-retrocaecal group<br>Patients who underwent surgery for signs of acute appendicitis and had intraoperative finding of the appendix not located in the retrocaecal position. | Procedure: Appendectomy<br>* Surgical procedure for removal of the appendix<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of patient with postoperative complications | surgical site infections, postoperative ileus, bleeding, internal complications, | 30 days after intervention (appendectomy) | 
| Number of patient who undergo converted appendectomy | Conversion from laparoscopic to open appendectomy | during the surgery | 
| Length of hospital stay | Length of hospital stay after the procedure in days | 30 days after intervention (appendectomy) | 
| Duration of procedure | Duration of appendectomy in minutes | Throughout the study period (1/2015-4/2020) |