Abstract

Aim: Although appendicitis is the most common surgical pathology of the abdomen, the diagnosis, treatment, and follow-up shows wide variations. We aimed to evaluate the approach Turkish pediatric surgeons to acute appendicitis.

Materials and Method: We sent a questionnaire consisting of 13 questions by e-mail for of 400 pediatric surgeons of Turkish Association of Pediatric Surgeons members.

Results: The 102 (25,5%) of 400 pediatric surgeons replied the questionnaire. The 73 (73%) of pediatric surgeons diagnosed acute appendicitis with physical examination and ultrasonography, 15 (15%) with physical examination and laboratory findings, 10 (10%) with abdominal computed tomography, 2 (2%) with MRI. The 21(21%) of the pediatric surgeons thought that appendectomy is an emergency operation. The 60 (60%) of the pediatric surgeons thought that appendectomy should be performed in the early period. The 19 (19%) of pediatric surgeons thought that an appendectomy is not an emergent operation. We asked to the pediatric surgeons approach to acute appendicitis after the night 23 o’clock. The 53 (53%) of pediatric surgeons were observing the patients until the next day and he operated the patient as a first case, 20 (20%) of pediatric surgeons when they were at the hospital, they immediately performed appendectomy. 17 (17%) observed the patients until next day and performed appendectomy after elective cases, 10 (10%) even though at home, he said no matter what time the patient received surgery. When we asked to the pediatric surgeons about nonoperative treatment of acute appendicitis, 71 (71%) surgeons said that nonoperative treatment has no place in treatment of acute appendicitis, 29 (29%) said that it can be applied in the some of selected cases. 42 (42%) of the pediatric surgeons have performed open appendectomy, 36 (36%) have performed open and three ports laparoscopic appendectomy, 18 (18%) have performed 3-ports laparoscopic, 4 (4%) have performed one port laparoscopic appendectomy. The 36 (35.64%) pediatric surgeons have been used drains in perforated appendicitis, 36 (35.64%) of them have been sometimes used, 29 (28.71%) of them have not used.

Conclusions: The majority of Turkish pediatric surgeons have used imaging methods for diagnosis, have thought that appendectomy is not an emergent operation but an operation should be done early, used drain, have preferred both open and laparoscopic appendectomy with close proportions.