Global attitudes in the management of acute appendicitis during COVID-19 pandemic: ACIE Appy Study
Ielpo, B; Podda, M; Pellino, G; Pata, F; Caruso, R; Gravante, G; Di Saverio, S; Gallo, Gaetano; Lui, Rashid; Orengia, Adam; Chowdary, Aditya; Kulkarni, Aditya; Kuvvetli, Adnan; Navarro, Adolfo; Pisanu, Adolfo; Smith, Adrian; Ibiricu, Adriana Cavero; Nacion, Aeris Jane D; Alsaleh, Ahmad; Alhazmi, Ahmad; Elmabri, Ahmad; Wani, Ajaz; Rencuzogullari, Ahmet; Lasarte, Aingeru Sarriugarte; Rubio, Ainhoa Valle; Bavikatte, Akshay; Kumar, Akshay; Jamiri, Al-Radjid; Padilla, Alain Michel Alvarado; Cacurri, Alban; de San Ildefonso, Alberto; Porcu, Alberto; Sartori, Alberto; Rocca, Aldo; Yáñez, Alejandro Paz; Becaria, Alejandro; SolÃs-Peña, Alejandro; Sretenović, Aleksandar; Urbistondo, Alex; Bandin, Alfonso; Najar, Alfonso; De Luca, Alessandro; Boddy, Alex; Charalabopoulos, Alexandros; Tzivanakis, Alexios; Amendola, Alfonso; Ramirez-Gutierrez de Velasco, Alfredo; Yildirim, Ali Cihat; Frontali, Alice; Toure, Alpha Oumar; GarcÃa-Granero, Alvaro; MartÃnez Roldan, Amaia; Sanz Larrainzar, Amaia; Ratnayake, Amila Sanjiva; Gonzalez-Ganso, Ana MarÃa; Minaya-Bravo, Ana M; Das, Andre; Bondurri, Andrea; Costanzi, Andrea; Lucchi, Andrea; Mazzari, Andrea; Musig, Andrea; Peloso, Andrea; Piano, Andrea; Police, Andrea; Mihailescu, Andrei; Pouy, Andrés; Romano, Angela; Iossa, Angelo; Leonetti, Anna Carmen; Guariniello, Anna; Isaac, Anna; Bovi, Anna Pia Delli; Chessa, Antonella; Tromba, Antonella; Ãlvarez MartÃnez, Antonio; Brillantino, Antonio; Caira, Antonio; Castaldi, Antonio; Ferronetti, Antonio; Giuliani, Antonio; Prestera, Antonio; Ramos-De la Medina, Antonio; Tarasconi, Antonio; Tornambè, Antonino; Picciariello, Arcangelo; Ioannidis, Argyrios; Leppäniemi, Ari; Khan, Arshad; Rashid, Arshad; Pérez-Sánchez, Arteaga Luis Eduardo; Mittal, Ashok; Mitul, Ashrarur Rahman; Mehraj, Asif; Laharwal, Asim; Dorismé, Asnel; Marinis, Athanasios; Iqbal, Atif; Moncada, Augusto; Braccio, Bartolomeo; Alkhafaji, Basim; de Andrés Asenjo, Beatriz; Martin-Perez, Beatriz; Pérez, Belinda Sánchez; Creavin, Ben; Calì, Benedetto; Pascotto, Beniamino; Stubbs, Benjamin; Retes, Benjamin Zavala; Jovanovic, Branislav; Goh, Brian Kp; Sensi, Bruno; Biddau, Carlo; Gazia, Carlo; Vallicelli, Carlo; Fagundes, Carlos Alberto; Cerdán Santacruz, Carlos; Chirico, Carlos; Gómez, Carlos Javier; Petrola, Carlos; Sánchez Rodriguez, Carlos; Yánez BenÃtez, Carlos; Dammaro, Carmelisa; Faro, Carmelo Lo; Reinke, Caroline; Dominguez Paez, Casandra; Oliva, Catalina; Paranjape, Charudutt; Thomas, Charlotte; Chia, Chi Fung; Kong, Chi Kwan; De Lucia, Chiara; Chao, Christian Ovalle; Arcudi, Claudio; Guerci, Claudio; Chia, Clement; Parise, Cristiano; Folliero, Cristina; Varela, Cristopher; Ferguson, Dalya M; Camacho, Daniel; Popowich, Daniel; Souza Lima, Daniel; Rega, Daniela; Delogu, Daniele; Zigiotto, Daniele; Vinci, Danilo; D'Antonio, Dario; Parini, Dario; Merlini, David Alessio; Zimmerman, David DE; Moro-Valdezate, David; Pertile, Davide; Giusti, Deborah Maria; Keller, Deborah S; Tarik, Delko; Kalivaçi, Denis; Mazingi, Dennis; Maldonado-Pintado, Diana Gabriela; Sasia, Diego; Linardoutsos, Dimitrios; Osilli, Dixon; Murrone, Domenico; Russello, Domenico; Rodas, Edgar; Acuña Roa, Edisson Alberto; Ricciardi, Edoardo; Rosso, Edoardo; Saladino, Edoardo; Flores-Villalba, Eduardo; Ruiz Ajs, Eduardo; Smith-Singares, Eduardo; Baili, Efstratia; Kouroumpas, Efstratios; Bourmpouteli, Eirini; Douka, Eleftheria; Martin-Perez, Elena; Guaitoli, Eleonora; Samadov, Elgun; Francone, Elisa; Vaterlini, Elisa; Morales, Emilio; Peña, Emilio; Zhao, Enhao; Del Pozo Andres, Eneko; Benzoni, Enrico; Erdas, Enrico; Pinotti, Enrico; Colás-Ruiz, Enrique; Aytac, Erman; Laterza, Ernesto; Agastra, Ervis; Foianini, Esteban; Moscoso, Esteban; Laviano, Estefania; Marra, Ester; Cardamone, Eugenia; Licardie, Eugenio; Mpaili, Eustratia; Pinna, Eva; Varo, Evaristo; Navarro, Fabian MartÃn; Marino, Fabio; Medas, Fabio; Romano, Fabio; Maraska, Fatlum; Saliu, Fatmir; Madrid, Fausto; Rosa, Fausto; Mastella, Federica; Gheza, Federico; Luvisetto, Federico; Alconchel, Felipe; Vieira, Felipe Monge; Pareja, Felipe; Agresta, Ferdinando; Luna, Fernanda; Bonilla, Fernando; Cordera, Fernando; Burdió, Fernando; Mendoza-Moreno, Fernando; Muñoz Flores, Fernando; Pardo Aranda, Fernando; Taylor, Fiona; Ramos, Flavia L; Fernandes, Flavio; Tropeano, Francesca Paola; Balestra, Francesco; Bianco, Francesco; Ceci, Francesco; Colombo, Francesco; Di Marzo, Francesco; Ferrara, Francesco; Lancellotti, Francesco; Lazzarin, Francesco; Litta, Francesco; Martini, Francesco; Pizza, Francesco; Roscio, Francesco; Virdis, Francesco; Blanco Antona, Francisco; Cervantes RamÃrez, Francisco; Fernandez, Francisco Miguel; Llinares, Francisco Oliver; Quezada, Francisco; Schlottmann, Francisco; Herrera-Almario, Gabriel; Massaferro, Gabriel; Bislenghi, Gabriele; van Ramshorst, Gabrielle; Gallo, Gaetano; Luglio, Gaetano; Bointas, Georgios; Kampouroglou, Georgios; Papadopoulos, Georgios; Arredondo Manrique, Gerardo; Calini, Giacomo; Nastri, Giacomo; Formisano, Giampaolo; Galiffa, Giampaolo; Palini, Gian Marco; Colucci, Gianluca; Pagano, Gianluca; Pellino, Gianluca; Vanni, Gianluca; Pattacini, Gianmaria Casoni; Gravante, Gianpiero; De Paola, Gilda; Lisi, Giorgio; Partida, Giovanna; Bellanova, Giovanni; De Nobili, Giovanni; Necchi, Giovanni Sammy; Sinibaldi, Giovanni; Tebala, Giovanni; Bagaglini, Giulia; Izzo, Giuliano; Argenio, Giulio; Brisinda, Giuseppe; Candilio, Giuseppe; Di Grezia, Giuseppe; Esposito, Giuseppe; Faillace, Giuseppe; Frazzetta, Giuseppe; La Gumina, Giuseppe; Nigri, Giuseppe; Romeo, Giuseppe; Chocarro AmatriaÃn, Gloria; Ortega, Gloria; Martin-Martin, Gonzalo; Stavrou, Gregor A; Gunadi; Ugon, Gustavo Armand; Machain, Gustavo; Marcucci, Gustavo; MartÃnez-Mier, Gustavo; Machain, Gustavo Miguel; Nari, Gustavo; Calvo, Haydée; Fathy, Hamada; Hamilto; Ahmed, Hazem; Faraj, Hazem; Nava, Hector; Ordas Macias, Hector; Nikaj, Herald; Solano, Heriberto; Khan, Huma Ahmed; Sánchez Alarcón, Humberto; Ebied, Husam; Giani, Iacopo; Villalabeitia Ateca, Ibabe; Neri, Ignacio; Alberdi San Roman, Igor; Fidoshev, Iliya; Martinez Rodriguez, Iñaki; Negoi, Ionut; Ortega, Irene; Bernescu, Irina; Russo, Iris Shari; Vincente RodrÃguez, Irune; Palomares, Irving; Baltazar, Isaac; Jaén Torrejimeno, Isabel; Cornejo Jurado, Isabel MarÃa; Reccia, Isabella; Hussain, Ishtiyaq; Brito Toledo, Ismael; Mora-Guzmán, Ismael; Dogaru, Iulia; Romic, Ivan; Balciscueta, Izaskun; Kenington, J Cleo; Sagolsem, Jackison; Jang, Jae Y; Olivier, James; Lammel-Lindemann, Jan; Dziakova, Jana; Roldán Villavicencio, Javier Ismael; Salinas, Javier; Pejanovic, Jelena; Parreira, Jose Gustavo; Jovanovic; Rincón Pérez, Jeny; AsReyes, Jeryl; Medina Luque, Jesus Antonio; Mak, Joanna; Salas Rodriguez, Joanne; Herrera Kok, Johnn Henry; Krook, Jon; Diaz-Elizondo, Jose Antonio; Castell, Jose; GarcÃa-Flores, José Eduardo; Jover Navalón, José MarÃa; Silva Rodrigues, Jose Mauro; Pereira, José; Castell Gómez, José Tomas; Bellido Luque, Juan; MartÃn Del Olmo, Juan Carlos; Salamea, Juan Carlos; Coronel Olivier, Juan Francisco; Blas Laina, Juan Luis; Ordoñez, Juliana Maria; Gutierrez, Julieta; Abba, Julio; Sofi, Junaid Ahmad; Sherafgan, Kashaf; Sahnan, Kapil; Yanaga, Katsuhiko; Beatson, Kevin; Asim, Laharwal; Alvarez, Laura; Siragusa, Leandro; Farber, Lee; Ong, Lester; Athanasios, Liarakos; GarcÃa-Bruña, Lorena; De Martino, Luca; Ferrario, Luca; Giordano, Luca; Gordini, Luca; Pio, Luca; Ponchietti, Luca; Moletta, Lucia; Curella, Luciano; Poggi, Luciano; Taglietti, Lucio; Bonavina, Luigi; Conti, Luigi; Goffredi, Luigi; Garcia Ruiz, Luis Angel; Barrionuevo, Luis; Fregoso, Luis Enrique; Cabrera, Luis F; Rodriguez, Luis G; Grande, Luis; Gregorio Osoria, Luis; Kantun Gonzalez, Luis Javier; Sánchez-Guillén, Luis; Tallon-Aguilar, Luis; Tresierra, Luis; Giavarini, Luisa; Hasabelnabi, Mahmoud; Odovic, Maja; Uemura, Mamoru; Khan, Mansoor; Artiles-Armas, Manuel; David, Mara; Di Martino, Marcello; Spampinato, Marcello Giuseppe; Ribeiro, Marcelo A F; Viola, Marcelo; Angrisani, Marco; Calussi, Marco; Cannistrà , Marco; Catarci, Marco; Cereda, Marco; Conte, Marco; Giordano, Marco; Pellicciaro, Marco; Marino, Marco Vito; Vaterlini, Maria E; Jiménez, MarÃa F; Lolli, MarÃa Giulia; Bellini, Maria Irene; Lemma, Maria; Chiarello, Maria Michela; Nicola, Maria; Arrigo, Mario; Caneda Mejia, Mario; Montes Manrique, Mario; Rodriguez-Lopez, Mario; Serradilla-MartÃn, Mario; Zambrano Lara, Mario; MartÃnez, Marisa; Bagnall, Mark; Peter, Mark; Cañón Lara, Marta; Jimenez Gomez, Marta; Paniagua-Garcia-Señorans, Marta; Perez Gonzalez, Marta; RutegÃ¥rd, Martin; Salö, Martin; Franceschilli, Marzia; Silveri, Massimiliano; Veroux, Massimiliano; Pezzulo, Massimo; Nardi, Matteo; Rottoli, Matteo; Tolonen, Matti; Pedraza Ciro, Mauricio; Zuluagua, Mauricio; Cannavò, Maurizio; Cervellera, Maurizio; Iacobone, Maurizio; Montuori, Mauro; Podda, Mauro; GarcÃa DomÃnguez, Melody; Bingol-Kologlu, Meltem; Tahir, Mian; Lim, Michael; Wilson, Michael Sj; Wilson, Michael; Campanelli, Michela; Bisaccia, Michele; De Rosa, Michele; Maruccia, Michele; Paterno, Michele; Pisano, Michele; Torre, Michele; Treviño, Michele; Zuolo, Michele; Hernandez Bartolome, Miguel A; Farina, Miguel; Pera, Miguel; Prieto Calvo, Miguel; Sotelo, Milagros; Thway, Min Myat; Hassan, Mohamed; Hassan, Mohamed Salah Eldin; Azfar, Mohammad; Bouhuwaish, Mohammad; Taha, Mohammad; Zaieem, Mohammad; Korkoman, Mohammed; Guraieb, Montserrat; Shalaby, Mostafa; Raza, Muhammad Asif; Younis, Muhammad Umar; Elhadi, Muhammed; Ali, Mujahid Zulfiqar; Quazi, Nadeem; Dudi-Venkata, Nagendra N; Alselaim, Nahar; Loria, Natasha; Villan RamÃrez, Nathalie; Than, Nay Win; Smart, Neil; Trelles, Nelson; Pinto, Nicanor; Allievi, Niccolò; Petrucciani, Niccolo; Antonacci, Nicola; Cillara, Nicola; Gica, Nicolae; Cristiana, Nicolaescu Diana; Nicolás, Nicolás; Falco, Nicolò; Pecorelli, Nicolò; Tamini, Nicolò; Dallas, Nikolaos Andreas; Machairas, Nikolaos; Brito, Noelia; Fieturi, Nura Ahmed; Ortega, Nuria; AvilaMercado, Octavio; Irkorucu, Oktay; Alsherif, Omar; Valles, Orestes; Ioannidis, Orestis; Hernández Palmas, Oscar; Hernandez Palmas, Oscar Isaac; Sanz Guadarrama, Oscar; Bozbiyik, Osman; Omelanczuk, Pablo; Ottolino, Pablo; Rodrigues, Pablo; Ruiz, Pablo; Campenni, Paola; Chiarade, Paola; Prieto Olivares, Paola; Baroffio, Paolo; Baroffio, Paolo; Wintringer, Pascal; Di Fronzo, Pasquale; Talento, Pasquale; Favoriti, Pasqualino; Sendino, Patricia; Marsanic, Patrizia; Mifsut, Patricia; Andrade, Paúl; Ajawin, Pawel; Ferri, Valentina; Massimiliano de Luca, Giuseppe; Ingallinella, Sara; Pueyo, Eva; Palmieri, Francesco; Silva, Jesus; Chin, Ken Min; Syn, Nicholas; Goh, Brian K P; Koh, Ye Xin; Tonini, Valeria; Gonzales-Ganso, Ana; Simó, Vicente; Diago, Maria Victoria; AbadÃa-Barnó, Pedro; Najar Castañeda, Pedro Alfonso; Sillas Arevalos, Pedro Omar; Palazón Bellver, Pedro; Koh, Peng Soon; Souza, Petry; Major, Piotr; Bali, Rajandeep Singh; Khattar, Rakesh Mohan; Melo, Renato Bessa; Ebrahiminia, Reza; Azar, Ricardo; Murga, Ricardo López; Caruso, Riccardo; Pirolo, Riccardo; Brady, Richard; Davies, Richard Justin; Dholakia, Rishi; Rattan, Rishi; Singhal, Rishi; Lim, Robert; Angelico, Roberta; Isernia, Roberta Maria; Tutino, Roberta; Faccincani, Roberto; Peltrini, Roberto; Carrera-Ceron, RocÃo; Tejos, Rodrigo; Kashyap, Rohit; Fajardo, Roosevelt; Lozito, Rosa; Madariaga Pareja, Royer; Garbarino, Sabrina; Di Saverio, Salomone; Morales-Conde, Salvador; Benli, Sami; Mansour, Sami; Flores, Samir; Limon Suarez, Samuel; Lopez Ben, Santiago; Fuentes, Sara; Napetti, Sara; Ortiz de Guzmán, Sara; Awad, Selmy; Weckmann Luján, Sergio A; Gentilli, Sergio; Grimaldi, Sergio; Olivares Pizarro, Sergio; Tayar, Serkan; Nabi, Shakeeb; Chan, Shannon M; Junaid, Sheikh; Rojas, Sidney; Monetti, Silvana; GarcÃa, Silvia; Salvans, Silvia; Tenconi, Silvia; Shaw, Simon; Santoni, Simone; Parra, Sofia Andrea; Cárdenas, SofÃa; Pérez-Bertólez, Sonia; Chiappetta, Sonja; Dessureault, Sophie; Delis, Spiros; Bonapasta, Stefano Amore; Rausei, Stefano; Scaringi, Stefano; Keswani, Sundeep; Ali, Syed Muhammad; Cetinkunar, Süleyman; Fung, Tak Lit Derek; Rawashdeh, Tariq; Nicolás López, Tatiana; De Campos, Tercio; Calderon Duque, Teresa; Perra, Teresa; Liakakos, Theodore; Daskalakis, Theodoros; Liakakos, Theodoros; Barnes, Thomas; Koëter, Tijmen; Zalla, Tiku; González, Tomás E; Elosua, Tomás; Campagnaro, Tommaso; Brown, Tommy; Luoto, Topi; Oumar, Touré Alpha; Giustizieri, Ugo; Grossi, Ugo; Bracale, Umberto; Rivas, Uriel; Sosa, Valentina; Testa, Valentina; Andriola, Valeria; Tonini, Valeria; Balassone, Valerio; Celentano, Valerio; Progno, Valerio; Raju, Varun; Carroni, Vanessa; Cavallaro, Venera; Katta, Venkateswara Rao; De Simone, Veronica; Romaguera, Vicent Primo; GarcÃa Orozco, Victor Hugo; Luraschi, Victor; Rachkov, Victor; Turrado-L, Victor; Visag-Castillo, Victor; Dowling, Victoria; Graham, Victoria; Papagni, Vincenzo; Vigorita, Vincenzo; Cordeiro Fonseca, Vinicius; Jimenez Carneros, Virginia; Bellato, Vittoria; Gonçalves, Walyson; Powers, William F; Grigg, William; Bechstein, Wolf O; Lim, Yu Bing; Altinel, Yuksel; Golubović, Zoran; Balciscueta, Zutoia
BACKGROUND:Surgical strategies are being adapted to face the COVID-19 pandemic. Recommendations on the management of acute appendicitis have been based on expert opinion, but very little evidence is available. This study addressed that dearth with a snapshot of worldwide approaches to appendicitis. METHODS:The Association of Italian Surgeons in Europe designed an online survey to assess the current attitude of surgeons globally regarding the management of patients with acute appendicitis during the pandemic. Questions were divided into baseline information, hospital organization and screening, personal protective equipment, management and surgical approach, and patient presentation before versus during the pandemic. RESULTS:Of 744 answers, 709 (from 66 countries) were complete and were included in the analysis. Most hospitals were treating both patients with and those without COVID. There was variation in screening indications and modality used, with chest X-ray plus molecular testing (PCR) being the commonest (19·8 per cent). Conservative management of complicated and uncomplicated appendicitis was used by 6·6 and 2·4 per cent respectively before, but 23·7 and 5·3 per cent, during the pandemic (both P < 0·001). One-third changed their approach from laparoscopic to open surgery owing to the popular (but evidence-lacking) advice from expert groups during the initial phase of the pandemic. No agreement on how to filter surgical smoke plume during laparoscopy was identified. There was an overall reduction in the number of patients admitted with appendicitis and one-third felt that patients who did present had more severe appendicitis than they usually observe. CONCLUSION:Conservative management of mild appendicitis has been possible during the pandemic. The fact that some surgeons switched to open appendicectomy may reflect the poor guidelines that emanated in the early phase of SARS-CoV-2.
PMID: 34157090
ISSN: 1365-2168
CID: 5443642