Treatment of Pediatric Appendicitis: Study Update | Cincinnati Children's скачать в хорошем качестве

Treatment of Pediatric Appendicitis: Study Update | Cincinnati Children's

https://www.cincinnatichildrens.org Beth Rymeski, DO: Hi, my name is Beth Rymeski. I’m one of the pediatric surgeons at Cincinnati Children’s here today to give a little update about pediatric appendicitis. As most of you know, pediatric appendicitis is a very common condition that affects about 70,000 children per year. And what seems to be about 90 percent of the population of kids we treat. However, the actual number is 7 percent of the U.S. population. As some of you may be aware, we just recently completed a 3½-year study as part of a multi-center trial looking at the treatment of pediatric appendicitis with antibiotics rather than surgery. So, I just wanted to update you guys about what that study was about and where we stand in terms of that at Cincinnati Children’s. So, this multi-center study was actually based on a pilot study that included over 100 patients and demonstrated a 75 percent success rate of non-operative I.e. antibiotic treatment of appendicitis at 1 year. The inclusion criteria for this study included patients 7-18 years old with less than 48 hours of symptoms. The patients had to have a white count of less than 18. And imaging studies either and Ultrasound or a CAT scan that demonstrated no appendicolith and an appendiceal diameter of 1.1 centimeters or less. If there was any concern for perforation on the study the patients were excluded as well as any patient who presented with an underlying history of chronic abdominal pain. This particular study has completed enrollment and the complete data is not available however from our from our preliminary reviews about 60-70% of our patients were successful in treating appendicitis with antibiotics. Meaning that they did not have recurrent appendicitis during the 1 year follow up and that they still have their appendix. There is quite a bit of data out there about appendicitis and treatment with antibiotics, mostly in adults. However, there are some other pediatric studies done outside of the U.S. These studies have demonstrated a variable success rate anywhere from 60s to 98 percent. And about a 10 percent incidence of failure of this treatment in the first 30 days after the antibiotic treatment. Importantly these studies have demonstrated little to no patients, treated with antibiotics who then went on to develop perforated appendicitis. Treatment of appendicitis with antibiotics rather than surgery could actually benefit children in terms of decreased cost of the overall hospital stay, fewer disability days and overall improved quality of life. Currently, at Cincinnati Children’s, we are not pursuing antibiotics as a first-line treatment for appendicitis until we know the full results of the study. However, in select patient populations and when families and patients ask for it, we have continued to offer this treatment. So, the takeaway points for at least this video are that antibiotics may be an alternative treatment strategy for the treatment of Pediatric Appendicitis compared to surgery. The jury is still out and we’re not offering it as routine treatment here at Cincinnati Children’s. However in select patient populations or in patients and families that ask us about this and want antibiotics rather than surgery we have continued to offer it. We hope you enjoyed this update and found it helpful. If you have any further questions or want to discuss this further please use the contact information on the screen.