Reflexiones en Torno a la Apendicitis Aguda

Appendectomy: Negative Appendectomy No Longer Ignored
Tetsuji Fujita, MD; Katuhiko Yanaga, MD
Arch Surg. 2007;142(11):1023-1025.

Early appendectomy has been the treatment of choice for patients with confirmed or suspected acute appendicitis. The surgical residents have been taught that although observation may reduce the rate of unnecessary appendectomy, such a policy will increase the rate of perforation, which undoubtedly results in increased morbidity and mortality. Whereas appendectomy has been a safe procedure with a mortality rate of 0.4% to 0.08% for uncomplicated appendicitis,1-2 in some series perforated appendicitis is associated with an unacceptable mortality rate as high as 12%.1 For patients with acute appendicitis, therefore, the perforation rate has been used as an index of quality of care. In a recent study, the association between time from the onset of symptoms and risk of appendiceal rupture was retrospectively studied in 219 patients who had undergone appendectomy for pathologically proven appendicitis.3 The risk was negligible within the first 24 hours.

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