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Type: Artigo
Title: Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines
Author: Saverio, Salomone di
Podda, Mauro
Simone, Belinda de
Ceresoli, Marco
Augustin, Goran
Gori, Alice
Boermeester, Marja
Sartelli, Massimo
Coccolini, Federico
Tarasconi, Antonio
de’ Angelis, Nicola
Weber, Dieter G.
Tolonen, Matti
Birindelli, Arianna
Biffl, Walter
Moore, Ernest E.
Kelly, Michael
Soreide, Kjetil
Kashuk, Jeffry
Broek, Richard Ten
Gomes, Carlos Augusto
Sugrue, Michael
Davies, Richard Justin
Damaskos, Dimitrios
Leppäniemi, Ari
Kirkpatrick, Andrew
Peitzman, Andrew B.
Fraga, Gustavo P.
Maier, Ronald V.
Coimbra, Raul
Chiarugi, Massimo
Sganga, Gabriele
Pisanu, Adolfo
de’ Angelis, Gian Luigi
Tan, Edward
Van Goor, Harry
Pata, Francesco
Carlo, Isidoro di
Chiara, Osvaldo
Litvin, Andrey
Campanile, Fabio C.
Sakakushev, Boris
Tomadze, Gia
Demetrashvili, Zaza
Latifi, Rifat
Abu-Zidan, Fakri
Romeo, Oreste
Segovia-Lohse, Helmut
Baiocchi, Gianluca
Costa, David
Rizoli, Sandro
Balogh, Zsolt J.
Bendinelli, Cino
Scalea, Thomas
Ivatury, Rao
Velmahos, George
Andersson, Roland
Kluger, Yoram
Ansaloni, Luca
Catena, Fausto
Abstract: Acute appendicitis (AA) is among the most common causes of acute abdominal pain. Diagnosis of AA is still challenging and some controversies on its management are still present among different settings and practice patterns worldwide. In July 2015, the World Society of Emergency Surgery (WSES) organized in Jerusalem the first consensus conference on the diagnosis and treatment of AA in adult patients with the intention of producing evidence-based guidelines. An updated consensus conference took place in Nijemegen in June 2019 and the guidelines have now been updated in order to provide evidence-based statements and recommendations in keeping with varying clinical practice: use of clinical scores and imaging in diagnosing AA, indications and timing for surgery, use of non-operative management and antibiotics, laparoscopy and surgical techniques, intra-operative scoring, and peri-operative antibiotic therapy. This executive manuscript summarizes the WSES guidelines for the diagnosis and treatment of AA. Literature search has been updated up to 2019 and statements and recommendations have been developed according to the GRADE methodology. The statements were voted, eventually modified, and finally approved by the participants to the consensus conference and by the board of co-authors, using a Delphi methodology for voting whenever there was controversy on a statement or a recommendation. Several tables highlighting the research topics and questions, search syntaxes, and the statements and the WSES evidence-based recommendations are provided. Finally, two different practical clinical algorithms are provided in the form of a flow chart for both adults and pediatric (< 16 years old) patients. The 2020 WSES guidelines on AA aim to provide updated evidence-based statements and recommendations on each of the following topics: (1) diagnosis, (2) non-operative management for uncomplicated AA, (3) timing of appendectomy and in-hospital delay, (4) surgical treatment, (5) intra-operative grading of AA, (6) ,management of perforated AA with phlegmon or abscess, and (7) peri-operative antibiotic therapy
Subject: Apendicite
Country: Reino Unido
Editor: Springer Nature
Rights: Aberto
Identifier DOI: 10.1186/s13017-020-00306-3
Date Issue: 2020
Appears in Collections:FCM - Artigos e Outros Documentos

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