Antibiotics vs appendectomy for uncomplicated acute appendicitis.
نویسندگان
چکیده
The term evidence-based medicine was first coined by Sackprognosis of disease, how to quantify disease (measureett and colleagues as “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients.” The key to practicing evidence-based medicine is applying the best current knowledge to decisions in individual patients. Medical knowledge is continually and rapidly expanding, and it is impossible for an individual clinician to read all themedical literature. For clinicians to practice evidence-based medicine, they must have the skills to read and interpret the medical literature so that they can determine the validity, reliability, credibility, and utility of individual articles. These skills are known as critical appraisal skills. Generally, critical appraisal requires that the clinician have some knowledge of biostatistics, clinical epidemiology, decision analysis, and economics as well as clinical knowledge. The Canadian Association of General Surgeons (CAGS) and the American College of Surgeons (ACS) jointly sponsor a program titled, “Evidence-Based Reviews in Surgery” (EBRS), supported by an educational grant from Ethicon Inc and Ethicon Endo Surgery Inc. The primary objective of this initiative is to help practicing surgeons improve their critical appraisal skills. During the academic year, 8 clinical articles are chosen for review and discussion. They are selected not only for their clinical relevance to general surgeons, but also because they cover a spectrum of issues important to surgeons; for example, causation or risk factors for disease, natural history or
منابع مشابه
Antibiotics alone versus appendectomy to treat uncomplicated acute appendicitis in adults: what do meta-analyses say?
BACKGROUND Primary appendectomy is the current standard of care for treating uncomplicated acute appendicitis, but interest in conservative treatment with antibiotics alone has been increasing in recent years. Clinical trials so far have shown controversial results. METHODS A series of meta-analyses were reviewed. Studies comparing surgery versus antibiotics alone for treating uncomplicated a...
متن کاملAntibiotic Therapy vs Appendectomy for Treatment of Uncomplicated Acute Appendicitis: The APPAC Randomized Clinical Trial.
IMPORTANCE An increasing amount of evidence supports the use of antibiotics instead of surgery for treating patients with uncomplicated acute appendicitis. OBJECTIVE To compare antibiotic therapy with appendectomy in the treatment of uncomplicated acute appendicitis confirmed by computed tomography (CT). DESIGN, SETTING, AND PARTICIPANTS The Appendicitis Acuta (APPAC) multicenter, open-labe...
متن کاملMeta-analysis of randomized trials comparing antibiotic therapy with appendectomy for acute uncomplicated (no abscess or phlegmon) appendicitis.
BACKGROUND The objective was to conduct a meta-analysis of randomized controlled trials evaluating the efficacy and morbidity of the management of acute uncomplicated (no abscess or phlegmon) appendicitis by antibiotics versus appendectomy. METHODS Appropriate trials were identified. The seven outcome variables were overall complication rate, treatment failure rate for index hospital admissio...
متن کاملConservative treatment for uncomplicated acute appendicitis in adults
Background: Acute appendicitis is a very common disease with a life time risk of approximately 7-8%. Worldwide, the standard of care for appendicitis is appendectomy that is to date considered generally a “routine and safe operation”. However, the mortality rate of appendectomy is 0.7% and 2.4% in patients without and with perforation, respectively. Aim: The paper aims to investigate the debate...
متن کاملConservative Treatment Versus Appendectomy for Acute Uncomplicated Appendicitis
Background: For more than 100 years, surgeons have been successfully performing appendectomy to treat acute appendicitis. However; there is recent trend to shift towards a more conservative approach. This work aimed to assess the nonoperative management in the treatment of acute uncomplicated appendicitis. Methods: One hundred and sixteen patients with uncomplicated acute appendicitis were enro...
متن کاملAppendectomy versus non-operative treatment for acute uncomplicated appendicitis in children: study protocol for a multicentre, open-label, non-inferiority, randomised controlled trial
Background Appendectomy is considered the gold standard treatment for acute appendicitis. Recently the need for surgery has been challenged in both adults and children. In children there is growing clinician, patient and parental interest in non-operative treatment of acute appendicitis with antibiotics as opposed to surgery. To date no multicentre randomised controlled trials that are appropri...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
- Journal of the American College of Surgeons
دوره 216 3 شماره
صفحات -
تاریخ انتشار 2013