Associations between sonographic findings and operative time of transumbilical laparoscopic-assisted appendectomy for acute appendicitis in children

Takahiro Hosokawa, Yoshitake Yamada, Yutaka Tanami, Yumiko Sato, Tetsuya Ishimaru, Hiroshi Kawashima, Eiji Oguma

Research output: Contribution to journalArticle

Abstract

OBJECTIVE. The purpose of this study is to evaluate the association between sonographic findings and the operative time of transumbilical laparoscopic-assisted appendectomy (TULAA) for appendicitis in children. MATERIALS AND METHODS. We included 131 children who underwent ultrasound within 24 hours before TULAA. We evaluated the associations between operative time and patients’ demographics, as well as the following sonographic findings: maximum outer wall diameter of the appendix, appendicolith, ascites (not echogenic), echogenic ascites, abscess formation, increased intraabdominal fat echo in the right lower quadrant (RLQ; 3-point scale), and the location of the appendix (three locations). The results were analyzed using simple linear regression or the t test and a multiple liner regression model. RESULTS. The mean (± SD) patient age was 9.50 ± 2.92 years (range, 3–15 years), and the mean operative time was 73.04 ± 36.56 minutes (range, 25–210 minutes). Univariate analysis showed that higher body mass index, greater maximum outer wall diameter of the appendix, higher grade of intraabdominal fat echo in the RLQ, presence of appendicolith, presence of echogenic ascites, abscess formation, and location of the appendix in the pelvis were associated with increased operative time. Multivariate analysis found that abscess formation and higher grade of increased intraabdominal fat echo in the RLQ were independently associated with operative time (both p < 0.05). CONCLUSION. Preoperative sonographic findings of abscess formation and increased intraabdominal fat echo in the RLQ were factors independently associated with prolonged operative time for TULAA. On the basis of these sonographic findings, surgeons may predict additional surgical procedures, including abscess aspiration or adhesiolysis, and operative time before beginning the operation.

Original languageEnglish
Pages (from-to)191-199
Number of pages9
JournalAmerican Journal of Roentgenology
Volume213
Issue number1
DOIs
Publication statusPublished - 2019 Jan 1

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Appendectomy
Appendicitis
Operative Time
Abscess
Fats
Ascites
Pelvis
Linear Models
Body Mass Index
Multivariate Analysis
Demography

Keywords

  • Appendicitis
  • Operative time
  • Sonography
  • Transumbilical laparoscopic-assisted appendectomy
  • Ultrasound

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Associations between sonographic findings and operative time of transumbilical laparoscopic-assisted appendectomy for acute appendicitis in children. / Hosokawa, Takahiro; Yamada, Yoshitake; Tanami, Yutaka; Sato, Yumiko; Ishimaru, Tetsuya; Kawashima, Hiroshi; Oguma, Eiji.

In: American Journal of Roentgenology, Vol. 213, No. 1, 01.01.2019, p. 191-199.

Research output: Contribution to journalArticle

Hosokawa, Takahiro ; Yamada, Yoshitake ; Tanami, Yutaka ; Sato, Yumiko ; Ishimaru, Tetsuya ; Kawashima, Hiroshi ; Oguma, Eiji. / Associations between sonographic findings and operative time of transumbilical laparoscopic-assisted appendectomy for acute appendicitis in children. In: American Journal of Roentgenology. 2019 ; Vol. 213, No. 1. pp. 191-199.
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AU - Hosokawa, Takahiro

AU - Yamada, Yoshitake

AU - Tanami, Yutaka

AU - Sato, Yumiko

AU - Ishimaru, Tetsuya

AU - Kawashima, Hiroshi

AU - Oguma, Eiji

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N2 - OBJECTIVE. The purpose of this study is to evaluate the association between sonographic findings and the operative time of transumbilical laparoscopic-assisted appendectomy (TULAA) for appendicitis in children. MATERIALS AND METHODS. We included 131 children who underwent ultrasound within 24 hours before TULAA. We evaluated the associations between operative time and patients’ demographics, as well as the following sonographic findings: maximum outer wall diameter of the appendix, appendicolith, ascites (not echogenic), echogenic ascites, abscess formation, increased intraabdominal fat echo in the right lower quadrant (RLQ; 3-point scale), and the location of the appendix (three locations). The results were analyzed using simple linear regression or the t test and a multiple liner regression model. RESULTS. The mean (± SD) patient age was 9.50 ± 2.92 years (range, 3–15 years), and the mean operative time was 73.04 ± 36.56 minutes (range, 25–210 minutes). Univariate analysis showed that higher body mass index, greater maximum outer wall diameter of the appendix, higher grade of intraabdominal fat echo in the RLQ, presence of appendicolith, presence of echogenic ascites, abscess formation, and location of the appendix in the pelvis were associated with increased operative time. Multivariate analysis found that abscess formation and higher grade of increased intraabdominal fat echo in the RLQ were independently associated with operative time (both p < 0.05). CONCLUSION. Preoperative sonographic findings of abscess formation and increased intraabdominal fat echo in the RLQ were factors independently associated with prolonged operative time for TULAA. On the basis of these sonographic findings, surgeons may predict additional surgical procedures, including abscess aspiration or adhesiolysis, and operative time before beginning the operation.

AB - OBJECTIVE. The purpose of this study is to evaluate the association between sonographic findings and the operative time of transumbilical laparoscopic-assisted appendectomy (TULAA) for appendicitis in children. MATERIALS AND METHODS. We included 131 children who underwent ultrasound within 24 hours before TULAA. We evaluated the associations between operative time and patients’ demographics, as well as the following sonographic findings: maximum outer wall diameter of the appendix, appendicolith, ascites (not echogenic), echogenic ascites, abscess formation, increased intraabdominal fat echo in the right lower quadrant (RLQ; 3-point scale), and the location of the appendix (three locations). The results were analyzed using simple linear regression or the t test and a multiple liner regression model. RESULTS. The mean (± SD) patient age was 9.50 ± 2.92 years (range, 3–15 years), and the mean operative time was 73.04 ± 36.56 minutes (range, 25–210 minutes). Univariate analysis showed that higher body mass index, greater maximum outer wall diameter of the appendix, higher grade of intraabdominal fat echo in the RLQ, presence of appendicolith, presence of echogenic ascites, abscess formation, and location of the appendix in the pelvis were associated with increased operative time. Multivariate analysis found that abscess formation and higher grade of increased intraabdominal fat echo in the RLQ were independently associated with operative time (both p < 0.05). CONCLUSION. Preoperative sonographic findings of abscess formation and increased intraabdominal fat echo in the RLQ were factors independently associated with prolonged operative time for TULAA. On the basis of these sonographic findings, surgeons may predict additional surgical procedures, including abscess aspiration or adhesiolysis, and operative time before beginning the operation.

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KW - Sonography

KW - Transumbilical laparoscopic-assisted appendectomy

KW - Ultrasound

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