Zusammenfassung
Hintergrund
Die Empfehlungen zur Therapie perityphlitischer Abszesse werden kontrovers diskutiert. Die primär perkutane Drainage hat sich als effektive Therapie herausgestellt. Unklar ist bislang jedoch die Notwendigkeit einer nachfolgenden Appendektomie im Intervall.
Patienten und Methode
In einer retrospektiven Studie wurden alle Patienten der Chirurgischen Universitätsklinik Greifswald, die zwischen Juni 1999 und Juni 2011 wegen eines perityphlitischen Abszesses (ICD-10 K35.32) behandelt wurden, ausgewertet.
Ergebnisse
Eingeschlossen wurden 38 Patienten. Hierbei erhielten 17 Patienten eine primär CT-gestützte Drainage und 21 Patienten wurden primär operiert. Die interventionelle Drainagetherapie zeigte sich als eine effektive Therapie des perithyphlitischen Abszesses. Eine primäre Operation ergab vergleichbare Ergebnisse und sollte bei Peritonismus angestrebt werden. Eine elektive Appendektomie im Intervall nach Drainageanlage ist nicht erforderlich.
Abstract
Background
The recommendations for the treatment of an appendiceal mass are still controversial. The need for staged appendectomy is still under discussion.
Patients and methods
In a retrospective study all patients with the diagnosis appendiceal mass (ICD 10 K35.32) treated in the surgical clinic of the University Clinic in Greifswald between June 1999 and June 2011 were analyzed.
Results
A total of 38 patients were included in the study whereby 17 patients (9 male and 8 female) were treated with drainage and antibiotics (group A) and 21 (14 male and 7 female) were treated by immediate surgery (group B). Nonsurgical therapy with drainage of the abscess was found to be efficient. Immediate surgical treatment was also effective and should be performed when signs of peritonitis exist. Interval appendectomy is not indicated.
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Einhaltung ethischer Richtlinien
Interessenkonflikt. L.I. Partecke, A. Müller, W. Kessler, S. Diedrich, C.-D. Heidecke, M. Patrzyk und B. Mensel geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.
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Partecke, L., Müller, A., Kessler, W. et al. Moderne Therapie perityphlitischer Abszesse. Chirurg 85, 622–627 (2014). https://doi.org/10.1007/s00104-013-2657-y
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DOI: https://doi.org/10.1007/s00104-013-2657-y