КЛАССИФИКАЦИИ И НЕОПЕРАТИВНОЕ ЛЕЧЕНИЕ ОСТРОГО АППЕНДИЦИТА У ВЗРОСЛЫХ: СРАВНИТЕЛЬНЫЙ АНАЛИЗ ЛИТЕРАТУРЫ
Аннотация
Вопрос неоперативного лечения острого аппендицита (ОА) остается дискуссионным в современной литературе. В последнее десятилетие проведены крупные исследования, посвященные данному подходу к лечению острого воспаления в червеобразном отростке (ЧО). Выводы, к которым приходят авторы статей, часто не согласуются между собой, а порой и противоположны друг другу. В обзоре отмечены различия зарубежных и отечественных классификаций ОА. В аналитической части произведено сравнение 6 оригинальных исследований, посвященных лечению ОА без операции, с целью определения причин различия результатов исследований и формирования общего представления о возможностях неоперативного лечения ОА и его недостатках.
Литература
Salminen P, Tuominen R, Paajanen H, Rautio T, Nordström P, Aarnio M, Rantanen T, Hurme S, Mecklin JP, Sand J, Virtanen J, Jartti A, Grönroos JM. Five-Year Follow-up of Antibiotic Therapy for Uncomplicated Acute Appendicitis in the APPAC Randomized Clinical Trial. JAMA. 2018;320(12):1259-1265. https://doi.org/10.1001/jama.2018.13201.
CODA Collaborative; Flum DR, Davidson GH, Monsell SE, Shapiro NI, Odom SR, Sanchez SE, Drake FT, Fischkoff K, Johnson J, Patton JH, Evans H, Cuschieri J, Sabbatini AK, Faine BA, Skeete DA, Liang MK, Sohn V, McGrane K, Kutcher ME, Chung B, Carter DW, Ayoung-Chee P, Chiang W, Rushing A, Steinberg S, et al. A Randomized Trial Comparing Antibiotics with Appendectomy for Appendicitis. N Engl J Med. 2020;383(20):1907-1919. https://doi.org/10.1056/NEJMoa2014320.
Rossijskoe obshhestvo hirurgov. “Ostryj appendicit u vzroslyh” 2020 [Internet]. Available from: https://clck.ru/34NK7D. (Russian).
Bhangu A, Søreide K, Di Saverio S, Assarsson JH, Drake FT. Acute appendicitis: modern understanding of pathogenesis, diagnosis, and management. Lancet. 2015;386(10000):1278-1287. https://doi.org/10.1016/S0140-6736(15)00275-5.
The American Association for the Surgery of Trauma. Table 1, Data Dictionaries for AAST Grading System for EGS Conditions [Internet]. Available from: https://clck.ru/34NLQc.
Di Saverio S, Podda M, De Simone B, Ceresoli M, Augustin G, Gori A, Boermeester M, Sartelli M, Coccolini F, Tarasconi A, De’ Angelis N, Weber DG, Tolonen M, Birindelli A, Biffl W, Moore EE, Kelly M, Soreide K, Kashuk J, Ten Broek R, Gomes CA, Sugrue M, Davies RJ, Damaskos D, Leppäniemi A, et al. Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines. World J Emerg Surg. 2020;15(1):27. https://doi.org/10.1186/s13017-020-00306-3.
Prechal D, Post S, Pechlivanidou I, Ronellenfitsch U. Feasibility, acceptance, safety, and effectiveness of antibiotic therapy as alternative treatment approach to appendectomy in uncomplicated acute appendicitis. Int J Colorectal Dis. 2019;34(11):1839-1847. https://doi.org/10.1007/s00384-019-03392-1.
Podda M, Serventi F, Mortola L, Marini S, Sirigu D, Piga M, Pisano M, Coppola M, Agresta F, Virdis F, Di Saverio S, Cillara N; ACTUAA Study Collaborative Working Group. A prospective non-randomized controlled, multicenter trial comparing Appendectomy and Conservative Treatment for Patients with Uncomplicated Acute Appendicitis (the ACTUAA study). Int J Colorectal Dis. 2017;32(11):1649-1660. https://doi.org/10.1007/s00384-017-2878-5.
Podda M, Poillucci G, Pacella D, Mortola L, Canfora A, Aresu S, Pisano M, Erdas E, Pisanu A, Cillara N; ACTUAA Study Collaborative Working Group. Appendectomy versus conservative treatment with antibiotics for patients with uncomplicated acute appendicitis: a propensity score-matched analysis of patient-centered outcomes (the ACTUAA prospective multicenter trial). Int J Colorectal Dis. 2021;36(3):589-598. https://doi.org/10.1007/s00384-021-03843-8.
Park HC, Kim MJ, Lee BH. The outcome of antibiotic therapy for uncomplicated appendicitis with diameters ≤ 10 mm. Int J Surg. 2014;12(9):897-900. https://doi.org/10.1016/j.ijsu.2014.07.011.
Park SS, Kim MJ, Kim JW, Park HC. Analysis of treatment success with new inclusion criteria for antibiotic therapy for uncomplicated appendicitis: A multicentre cohort study. Int J Clin Pract. 2021;75(4):e13840. https://doi.org/10.1111/ijcp.13840.
CODA Collaborative; Davidson GH, Flum DR, Monsell SE, Kao LS, Voldal EC, Heagerty PJ, Fannon E, Lavallee DC, Bizzell B, Lawrence SO, Comstock BA, Krishnadasan A, Winchell RJ, Self WH, Thompson CM, Farjah F, Park PK, Alam HB, Saltzman D, Moran GJ, Kaji AH, DeUgarte DA, Salzberg M, Ferrigno L, Mandell KA, et al. Antibiotics versus Appendectomy for Acute Appendicitis – Longer-Term Outcomes. N Engl J Med. 2021;385(25):2395-2397. https://doi.org/10.1056/NEJMc2116018.
Ukai T, Shikata S, Takeda H, Dawes L, Noguchi Y, Nakayama T, Takemura YC. Evidence of surgical outcomes fluctuates over time: results from a cumulative meta-analysis of laparoscopic versus open appendectomy for acute appendicitis. BMC Gastroenterol. 2016;16:37. https://doi.org/10.1186/s12876-016-0453-0.
CODA Collaborative; Flum DR, Davidson GH, Monsell SE, Shapiro NI, Odom SR, Sanchez SE, Drake FT, Fischkoff K, Johnson J, Patton JH, Evans H, Cuschieri J, Sabbatini AK, Faine BA, Skeete DA, Liang MK, Sohn V, McGrane K, Kutcher ME, Chung B, Carter DW, Ayoung-Chee P, Chiang W, Rushing A, Steinberg S, et al. A Randomized Trial Comparing Antibiotics with Appendectomy for Appendicitis. N Engl J Med. 2020;383(20):1907-1919. https://doi.org/10.1056/NEJMoa2014320.
2.png)
