World Journal of Emergency Surgery (Mar 2020)
The SIFIPAC/WSES/SICG/SIMEU guidelines for diagnosis and treatment of acute appendicitis in the elderly (2019 edition)
- Paola Fugazzola,
- Marco Ceresoli,
- Vanni Agnoletti,
- Ferdinando Agresta,
- Bruno Amato,
- Paolo Carcoforo,
- Fausto Catena,
- Osvaldo Chiara,
- Massimo Chiarugi,
- Lorenzo Cobianchi,
- Federico Coccolini,
- Alessandro De Troia,
- Salomone Di Saverio,
- Andrea Fabbri,
- Carlo Feo,
- Francesco Gabrielli,
- Angela Gurrado,
- Angelo Guttadauro,
- Leonardo Leone,
- Daniele Marrelli,
- Luca Petruzzelli,
- Nazario Portolani,
- Francesco Paolo Prete,
- Alessandro Puzziello,
- Massimo Sartelli,
- Giorgio Soliani,
- Mario Testini,
- Salvatore Tolone,
- Matteo Tomasoni,
- Gregorio Tugnoli,
- Pierluigi Viale,
- Monica Zese,
- Offir Ben Ishay,
- Yoram Kluger,
- Andrew Kirkpatrick,
- Luca Ansaloni
Affiliations
- Paola Fugazzola
- General and Emergency Surgery Department, Bufalini Hospital
- Marco Ceresoli
- General Surgery Department, Milano-Bicocca University, School of Medicine and Surgery
- Vanni Agnoletti
- Intensive Care Unit, Bufalini Hospital
- Ferdinando Agresta
- General Surgery, Civil Hospital - ULSS19
- Bruno Amato
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”
- Paolo Carcoforo
- Department of Surgery, S. Anna University Hospital and University of Ferrara
- Fausto Catena
- Emergency and Trauma Surgery, Maggiore Hospital
- Osvaldo Chiara
- Emergency and Trauma Surgery, Niguarda Hospital
- Massimo Chiarugi
- Emergency Surgery Unit, State University of Pisa, Cisanello Hospital
- Lorenzo Cobianchi
- Department of General Surgery, Fondazione IRCCS Policlinico San Matteo
- Federico Coccolini
- Emergency Surgery Unit, State University of Pisa, Cisanello Hospital
- Alessandro De Troia
- Department of Surgery, S. Anna University Hospital and University of Ferrara
- Salomone Di Saverio
- Colorectal Unit, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust
- Andrea Fabbri
- Department of Emergency Medicine, Morgagni-Pierantoni Hospital
- Carlo Feo
- Department of Surgery, S. Anna University Hospital and University of Ferrara
- Francesco Gabrielli
- General Surgery Department, Milano-Bicocca University, School of Medicine and Surgery
- Angela Gurrado
- Department of Biochemical Sciences and Human Oncology, University of Medical School “A. Moro” of Bari
- Angelo Guttadauro
- General Surgery Department, Milano-Bicocca University, School of Medicine and Surgery
- Leonardo Leone
- General and Oncological Surgery, Filippo Neri Hospital
- Daniele Marrelli
- Department of Medicine, Surgery and Neurosciences, University of Siena
- Luca Petruzzelli
- Department of Emergency Surgery, Città della Salute e della Scienza University Hospital
- Nazario Portolani
- Department of Clinical and Experimental Sciences, Surgical Clinic, University of Brescia
- Francesco Paolo Prete
- Endocrine, Digestive and Emergency Surgery Department, University of Medical School of Bari
- Alessandro Puzziello
- General Surgery, Salerno University
- Massimo Sartelli
- Department of Surgery, Macerata Hospital
- Giorgio Soliani
- Department of Surgery, S. Anna University Hospital and University of Ferrara
- Mario Testini
- Endocrine, Digestive and Emergency Surgery Department, University of Medical School of Bari
- Salvatore Tolone
- General, Mininvasive and Bariatric Surgery Unit, Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli
- Matteo Tomasoni
- General and Emergency Surgery Department, Bufalini Hospital
- Gregorio Tugnoli
- Trauma Surgery Unit, Maggiore Hospital Regional Emergency Surgery and Trauma Center, Bologna Local Health District
- Pierluigi Viale
- Operative Unit of Infectious Diseases, S. Orsola-Malpighi University Hospital
- Monica Zese
- Department of Surgery, S. Anna University Hospital and University of Ferrara
- Offir Ben Ishay
- Division of General Surgery, Rambam Health Care Campus
- Yoram Kluger
- Division of General Surgery, Rambam Health Care Campus
- Andrew Kirkpatrick
- Departments of General Acute Care, Abdominal Wall Reconstruction and Trauma Surgery, Foothills Medical Centre
- Luca Ansaloni
- General and Emergency Surgery Department, Bufalini Hospital
- DOI
- https://doi.org/10.1186/s13017-020-00298-0
- Journal volume & issue
-
Vol. 15,
no. 1
pp. 1 – 15
Abstract
Abstract The epidemiology and the outcomes of acute appendicitis in elderly patients are very different from the younger population. Elderly patients with acute appendicitis showed higher mortality, higher perforation rate, lower diagnostic accuracy, longer delay from symptoms onset and admission, higher postoperative complication rate and higher risk of colonic and appendiceal cancer. The aim of the present work was to investigate age-related factors that could influence a different approach, compared to the 2016 WSES Jerusalem guidelines on general population, in terms of diagnosis and management of elderly patient with acute appendicitis. During the XXIX National Congress of the Italian Society of Surgical Pathophysiology (SIFIPAC) held in Cesena (Italy) in May 2019, in collaboration with the Italian Society of Geriatric Surgery (SICG), the World Society of Emergency Surgery (WSES) and the Italian Society of Emergency Medicine (SIMEU), a panel of experts participated to a Consensus Conference where eight panelists presented a number of statements, which were developed for each of the four topics about diagnosis and management of acute appendicitis in elderly patients, formulated according to the GRADE system. The statements were then voted, eventually modified and finally approved by the participants to the Consensus Conference. The current paper is reporting the definitive guidelines statements on each of the following topics: diagnosis, non-operative management, operative management and antibiotic therapy.
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