Turkiye Klinikleri Journal of Medical Sciences

.: ORIGINAL RESEARCH
Comparison of the 'Patient Management and Outcomes' of the Pediatric Patient Groups Who Had Appendectomy During the COVID-19 Pandemic Period and the Pre-Pandemic Period in Terms of the Efficiency of the Management Plan: Cross-Sectional Research
COVID-19 Pandemi Dönemi ve Pandemi Öncesi Dönemde Apendektomi Uygulanan Pediatrik Hasta Gruplarının Hasta Yönetimi ve Sonuçlarının Yönetim Planının Etkinliği Açısından Karşılaştırılması: Kesitsel Araştırma
Denizay AVCIa , Ülgen ÇELTİKa , Mustafa Orkan ERGÜNa , Emre DİVARCIa , Geylani ÖZOKa , Ahmet ÇELİKa
aDepartment of Pediatric Surgery, Ege University Faculty of Medicine, İzmir, Türkiye
Turkiye Klinikleri J Med Sci. 2023;43(3):239-45
doi: 10.5336/medsci.2022-95123
Article Language: EN
Full Text
ABSTRACT
 Objective: The restrictions in national policies applied in hospital and patient admissions during the coronavirus disease-2019 pandemic have been observed to have caused delays and additional problems in patient management. The aim of this study was to compare the number and rates of negative appendectomy and complicated appendicitis in patients who underwent appendectomy before and during the pandemic in our clinic. Material and Methods: Patients who presented with abdominal pain to our clinic or were consulted between January 2019 and May 2021 were evaluated retrospectively. The cases were categorized into two groups pre-pandemic (1.1.2019-29.2.2020) and pandemic period (11.3.2020-31.5.2021). In both periods, patients underwent laparoscopic appendectomy. In addition, patients were grouped as negative, non-complicated, and complicated according to pathology results. Results: 324 patients were hospitalized during the pre-pandemic period due to ''abdominal pain.'' Exploration was done in 184 (M-F: 59%-41%) patients with suspected appendicitis. On histopathological examination, negative appendectomy was found in 16 (8.7%), noncomplicated in 113 (68.48%), and complicated in 55 (31.52%) of the patients who were operated on. Post-pandemic period, 232 patients were hospitalized due to abdominal pain. Exploration was done in 162 (M-F: 59%-41%) patients. On histopathological examination, negative appendectomy was found in 11 (6.8%), non-complicated in 100 (66.23%), and complicated in 51 (33.7%) of the patients who were operated on. Conclusion: According to the results of the data, no adverse effects were observed on complications or misdiagnosis due to the changing patient management regarding inpatient follow-up and surgical intervention in our clinic during the pandemic period.

Keywords: COVID-19; appendicitis; pediatric; abdominal pain; acute abdomen
ÖZET
 Amaç: Koronavirüs hastalığı-2019 pandemi döneminde hastane başvuruları ve hasta kabulünde uygulanan ulusal programlardaki kısıtlamaların hasta yönetiminde gecikme ya da ek sorunlara neden olduğu gözlemlenmiştir. Bu çalışmada kliniğimizde pandemi öncesi dönemde ve pandemi döneminde apendektomi uygulanan hastaların negatif apendektomi ve komplike apandisit sayı ve oranları yönünden karşılaştırılması amaçlanmıştır. Gereç ve Yöntemler: Kliniğimize Ocak 2019-Mayıs 2021 tarihleri arasında karın ağrısı şikâyeti ile başvurmuş veya konsülte edilmiş hastalar geriye dönük olarak değerlendirildi. Olgular pandemi öncesi dönem (1.1.2019-29.2.2020) ve pandemi dönemi (11.3.2020-31.5.2021) olmak üzere 2 gruba ayrıldı. Her iki dönemde de hastalara laparoskopik apendektomi uygulandı. Hastalar patoloji sonuçlarına göre negatif apendektomi, nonkomplike apandisit ve komplike apandisit olarak gruplandırıldı. Bulgular: Pandemi öncesi dönemde toplam 324 hasta ''karın ağrısı'' nedeniyle kliniğimize yatırıldı. Apandisit şüphesi olan 184 (E-K: %59-%41) hastaya laparoskopik apendektomi uygulandı. Histopatolojik incelemede opere edilen hastaların 16'sında (%8,7) negatif apendektomi, 113'ünde (%68,48) nonkomplike apandisit, 55'inde (%31,52) komplike apendisit saptandı. Pandemi döneminde 232 hasta karın ağrısı nedeniyle kliniğimize yatırıldı. 162 (E-K: %59-%41) hastaya laparoskopik apendektomi uygulandı. Histopatolojik incelemede opere edilen hastaların 11'inde (%6,8) negatif apendektomi, 100'ünde (%66,23) nonkomplike apandisit, 51'inde (%33,7) komplike apandisit saptandı. Sonuç: Toplanan verilerin istatistiksel değerlendirme sonuçlarına göre pandemi döneminde kliniğimizde yatarak izlem ve cerrahi girişim ile ilgili değişen hasta yönetiminin; komplikasyon veya yanlış tanı üzerine olumsuz etkisi gözlenmemiştir.

Anahtar Kelimeler: COVID-19; apandisit; pediatri; karın ağrısı; akut batın
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