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. 2022 Sep;46(9):2021-2035.
doi: 10.1007/s00268-022-06649-z. Epub 2022 Jul 9.

Evolving Trends in the Management of Acute Appendicitis During COVID-19 Waves: The ACIE Appy II Study

Francesco Pata #  1   2 , Marcello Di Martino #  3 , Mauro Podda #  4 , Salomone Di Saverio  5 , Benedetto Ielpo  6 , Gianluca Pellino  7   8 ; ACIE Appy Study Collaborative
Collaborators, Affiliations

Evolving Trends in the Management of Acute Appendicitis During COVID-19 Waves: The ACIE Appy II Study

Francesco Pata et al. World J Surg. 2022 Sep.

Erratum in

Abstract

Background: In 2020, ACIE Appy study showed that COVID-19 pandemic heavily affected the management of patients with acute appendicitis (AA) worldwide, with an increased rate of non-operative management (NOM) strategies and a trend toward open surgery due to concern of virus transmission by laparoscopy and controversial recommendations on this issue. The aim of this study was to survey again the same group of surgeons to assess if any difference in management attitudes of AA had occurred in the later stages of the outbreak.

Methods: From August 15 to September 30, 2021, an online questionnaire was sent to all 709 participants of the ACIE Appy study. The questionnaire included questions on personal protective equipment (PPE), local policies and screening for SARS-CoV-2 infection, NOM, surgical approach and disease presentations in 2021. The results were compared with the results from the previous study.

Results: A total of 476 answers were collected (response rate 67.1%). Screening policies were significatively improved with most patients screened regardless of symptoms (89.5% vs. 37.4%) with PCR and antigenic test as the preferred test (74.1% vs. 26.3%). More patients tested positive before surgery and commercial systems were the preferred ones to filter smoke plumes during laparoscopy. Laparoscopic appendicectomy was the first option in the treatment of AA, with a declined use of NOM.

Conclusion: Management of AA has improved in the last waves of pandemic. Increased evidence regarding SARS-COV-2 infection along with a timely healthcare systems response has been translated into tailored attitudes and a better care for patients with AA worldwide.

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Conflict of interest statement

The authors have no conflict of interests to disclose.

Figures

Fig. 1
Fig. 1
Screening policies in patients with acute appendicitis for SARS-CoV-2 infection during 2020 and 2021
Fig. 2
Fig. 2
Types of screening in patients with acute appendicitis for SARS-CoV-2 infection during 2020 and 2021
Fig. 3
Fig. 3
Management of uncomplicated appendicitis in 2020 and 2021
Fig. 4
Fig. 4
Management of complicated appendicitis in 2020 and 2021
See this image and copyright information in PMC

Comment in

References

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