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Inicio Cirugía Española (English Edition) Response to «National survey on the treatment of acute appendicitis in Spain du...
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Vol. 99. Issue 2.
Pages 168-169 (February 2021)
Vol. 99. Issue 2.
Pages 168-169 (February 2021)
Letter to the Editor
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Response to «National survey on the treatment of acute appendicitis in Spain during the initial period of the COVID-19 pandemic»
Respuesta a «Encuesta nacional sobre el tratamiento de la apendicitis aguda en España durante la fase inicial de la pandemia por COVID-19»
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Clara Giménez Francésa,
Corresponding author
clara.gf92@gmail.com

Corresponding author.
, Miguel Ruiz Marína,b, Pedro López Moralesa, Antonio Albarracín Marín-Blázqueza,b,c
a Servicio de Cirugía General, Hospital General Universitario Reina Sofía, Murcia, Spain
b Facultad de Medicina, Universidad Católica San Antonio, Murcia, Spain
c Cátedra de Cirugía, Facultad de Medicina, Universidad Católica San Antonio, Murcia, Spain
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Cir Esp. 2021;99:396-710.1016/j.cireng.2021.04.010
Benedetto Ielpo, Mikel Prieto, Irene Ortega, Miguel Ángel Gómez-Bravo, José Manuel Ramia
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To the Editor:

We have read with interest the article by Prieto et al.1 about the survey on the treatment of acute appendicitis during the COVID-19 pandemic, to which we would like to add the experience of our hospital.

Our perception was that urgent surgical disease presented during this period in more advanced phases, which was attributed to the state of confinement and the fear of possible infection by going to a medical center1. To try to confirm our suspicion, we compared the time of evolution and intraoperative findings (among other data) of patients diagnosed with appendicitis from March 15 to June 20, 2020 with patients who were treated surgically during the same period in 2019.

The series included 94 patients, 44 operated on during the pandemic (group 1) and 50 in 2019 (group 2). Group 1 consisted of 28 men and 16 women, with a mean age of 37.18 years; and group 2, 30 men and 20 women, with a mean age of 37.88 years. The recommendations of the Spanish Association of Surgeons2 were followed, including preoperative determination of possible COVID-19 infection by chest radiography, computed tomography (CT) and/or real-time polymerase chain reaction (RT-PCR). There were no pre- or postoperative positive cases. When we compared the cases during confinement with cases from the same period the year before, we found that, during confinement, 16 patients were treated surgically, while in 2019 the total was 31.

Regarding the days of clinical evolution, in group 1 the mean was 2 days (±1.73 days), and in group 2 it was 2.27 days (±2.83 days), with no statistically significant differences. In the intraoperative findings, we found that 16 cases (36.4%) in group 1 and 22 in group 2 (44%) were classified as phlegmonous, while 11 cases in group 1 (25%) and 15 in group 2 (30%) were purulent, finding no statistically significant differences between the two groups. As for gangrenous appendicitis, 17 were found in group 1 (38.6%) compared to 12 in group 2 (24%), although this was not statistically significant. In addition, we found that the laparoscopic approach was more frequent in group 1 (100 vs. 84%; P = .006). It was also more common for the primary surgeon to be a resident in group 1 versus 2, which was statistically significant (81.82% vs. 58%; P = .013).

In conclusion, we did not find differences in the time of evolution or in the severity of appendicitis during the pandemic. We attribute these results to the fact that the impact of the COVID-19 pandemic was lower in Murcia than in other regions, with a total of 1638 cases during lockdown3.

References
[1]
M. Prieto, B. Ielpo, M. Jiménez Fuertes, M.C. González Sánchez, E. Martín Antona, J.M. Balibrea, et al.
Encuesta nacional sobre el tratamiento de la apendicitis aguda en España durante la fase inicial de la pandemia por COVID-19.
[2]
J.M. Balibrea, J.M. Badia, I. Rubio Pérez, E. Martín Antona, E. Álvarez Peña, S. García Botella, et al.
Manejo quirúrgico de pacientes con infección por COVID-19 Recomendaciones de la Asociación Española de Cirujanos.
Cir Esp., 98 (2020), pp. 249-306
[3]
Gobierno de España. Enfermedad por nuevo coronavirus COVID-19. Available from: https://www.mscbs.gob.es/profesionales/saludPublica/ccayes/alertasActual/nCov/documentos/Actualizacion_142_COVID-19.pdf [Accessed 10 October 2020].

Please cite this article as: Giménez Francés C, Ruiz Marín M, López Morales P, Albarracín Marín-Blázquez A. Respuesta a «Encuesta nacional sobre el tratamiento de la apendicitis aguda en España durante la fase inicial de la pandemia por COVID-19». Cir Esp. 2021;99:168–169.

Copyright © 2020. AEC
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