科研之友
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摘要
A report published in February 2014 by the Directorate of Research, Studies, Evaluation and Statistics (DREES) of the ministry of Social Affairs and Health highlights the long decline in the frequency of appendectomy in France [1]. The frequency of appendectomy has fallen from more than 300,000 cases annually in the 1980s to 83,400 in 2012, a nearly four-fold decrease (Fig. 1). This analysis based on Program of medicalization of information systems (PMSI) data also provides two more specific bits of information: the rate of serious or complicated forms of appendicitis (appendiceal abscess or peritonitis) has remained relatively stable, while the seasonable variability of non-complicated appendicitis has decreased from 1997 through 2012. The authors feel that this is related to "a more timely recourse to appropriate surgical care" through the use of additional diagnostic testing (laboratory and clinical scores, ultrasound, CT scan). In the authors' opinion, this decreased rate of appendectomy bears witness to "a change of attitude with regard to appendicitis by family practitioners, pediatricians and surgeons as well as by families." But since this study evaluated appendectomy rather than appendicitis, one can not exclude the possibility that the decrease in the rate of appendectomy might also be due to a decline in the incidence of appendicitis due to improved hygiene and dietary habits [2] of the French population. This study confirms the perception shared by all practitioners: we operate less and less frequently on appendicitis. Older surgeons have lived through a period when our professors forbade leaving a patient with appendicitis unoperated overnight while awaiting a change of on-call surgeons. In recent years, surgeons have begun to recognize that "appendicitis" is not a single entity but rather a variety of types of appendicitis that require different management strategies.
- 出版日期2014-10
