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MUCOSECTOMY IN COMPLICATED APPENDICITIS

Author(s)
Fahad Ali Khan Pakistan Institute of Medical Sciences, Islamabad Paksitan
Syeda Rifaat Qamar Naqvi Combined Military Hospital Rawalpindi, Pakistan
Ayesha Khan Combined Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi, Pakistan
Babar Sultan Ayub Medical Complex Abbottabad Pakistan
Anam Haider Army Medical College/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Rehana Khadim Army Medical College/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Palwasha Khan Abu Usman Hospital Peshawar Pakistan
Zaheer Ud Din Qureshi Ayub Medical Complex Abbottabad Pakistan
Abstract
Objective: To describe the technique and results of mucosectomy; A surgical technique that is easy to perform, and has a lower morbidity and complication rate as compared to standard appendectomy in cases of complicated appendicitis. Study Design: Quasi-experimental study. Place and Duration of Study: Surgical - A Unit, Ayub Teaching Hospital, in Abbottabad, from Mar 2017 to Mar 2019. Methodology: Patients included were those who presented with appendicular mass, phlegmon, recurrent appendicitis, appendicitis in uncommon locations, presence of adhesions, those cases of appendicular mass and phlegmon which was either not responding to medical treatment, or diagnosed per operatively being clinically not palpable or not seen on ultrasound. Per operative and post-operative variables were documented and analyzed. In mucosectomy, thesubserosal portion of the appendix i-emuscularis and mucosa of the appendix was dissected out from the serosa after ligation of the appendicular base, or ligation done after delivering the appendix out of the serosa. The serosa that was adherent to the surrounding gut, omentum or other viscera was left intact. Results: A total of 192 patients were included in this study, half of which underwent standard appendectomy and a mucosectomy was performed on the rest. The mean time of surgery was 30 ± 1.2min as compared to the standard appendectomy group (55min ± 3.6). More than half of the patients undergoing standard appendectomy required extension of the incision (56.2%), and only 8% required so from those on whom mucosectomy was performed. Per operative hemorrhage was seen in 32.2%, however inmucosectomy group only 1%. Conclusion: Mucosectomy is a safer modification of standard appendicectomy in patients with appendicular mass, early mass formation, phlegmon, recurrent appendicitis and where the appendix is in an uncommon site, inflamed and adherent.
Publication Details
Page(s) 706-709
DOI DOI not available
Published Journal: Pakistan Armed Forces Medical Journal, Volume: 71, Issue: 2, Year: 2021

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Keywords
Appendectomy, Appendicular mass, Mucosectomy, Phlegmon
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