Penatalaksanaan Appendicitis

Oleh :

dr. Erika Gracia

Tujuan penatalaksanaan appendicitis adalah meredakan gejala akut dengan efek samping seminimal mungkin; serta memilih penatalaksanaan yang sebisa mungkin tidak invasif. Namun, pada kasus dimana harus dilakukan tindakan bedah, maka tujuan tata laksana tambahan adalah pencegahan komplikasi, misalnya infeksi luka; dengan lama rawat sependek mungkin dan pasien dapat menjalani aktivitas normal secepat mungkin.[10,11]

Penatalaksanaan definitif appendicitis adalah dengan apendiktomi. Sebelum dilakukan tindakan apendiktomi, pasien dapat diberikan resusitasi cairan, analgesik, dan antibiotik intravena.[1]

Terapi Suportif

Referensi

1. Snyder MJ, Guthrie M, Cagle S. Acute Appendicitis: Efficient Diagnosis and Management. Am Fam Physician. 2018 Jul 1;98(1):25–33.
3. Stringer MD. Acute appendicitis. J Paediatr Child Health. 2017;53(11):1071–6.
4. Kumar S, Jalan A, Patowary BN, Shrestha S. Laparoscopic Appendectomy Versus Open Appendectomy for Acute Appendicitis: A Prospective Comparative Study. Kathmandu Univ Med J KUMJ. 2016 Sep;14(55):244–8.
6. Craig S. Appendicitis: Practice Essentials, Background, Anatomy. Medscape, 2021. https://emedicine.medscape.com/article/773895-overview#a1
10. D'Souza N, Nugent K. Appendicitis. BMJ Clin Evid. 2014;2014:0408. Published 2014 Dec 8.
11. Krzyzak M, Mulrooney SM. Acute Appendicitis Review: Background, Epidemiology, Diagnosis, and Treatment. Cureus. 2020;12(6):e8562. Published 2020 Jun 11. doi:10.7759/cureus.8562
20. Salminen P, Paajanen H, Rautio T, Nordström P, Aarnio M, Rantanen T, Tuominen R, Hurme S, Virtanen J, Mecklin JP, Sand J, Jartti A, Rinta-Kiikka I, Grönroos JM. Antibiotic Therapy vs Appendectomy for Treatment of Uncomplicated Acute Appendicitis: The APPAC Randomized Clinical Trial. JAMA. 2015 Jun 16;313(23):2340-8. doi: 10.1001/jama.2015.6154.
21. CODA Collaborative, Flum DR, Davidson GH, Monsell SE, Shapiro NI, Odom SR, et al. A Randomized Trial Comparing Antibiotics with Appendectomy for Appendicitis. N Engl J Med. 2020 Nov 12;383(20):1907–19.
22. Martin RF. Acute appendicitis in adults: Clinical manifestations and differential diagnosis. Uptodate. 2021.
23. Smink D, Soybel DI. Management of acute appendicitis in adults. Uptodate. 2022.
24. United Kingdom National Surgical Research Collaborative, Bhangu A. Safety of short, in-hospital delays before surgery for acute appendicitis: multicentre cohort study, systematic review, and meta-analysis. Ann Surg 2014; 259:894.
25. Gurien LA, Burford JM, Bonasso PC, Dassinger MS. Resource savings and outcomes associated with outpatient laparoscopic appendectomy for nonperforated appendicitis. J Pediatr Surg 2017; 52:1760.
26. Cairo SB, Raval MV, Browne M, et al. Association of Same-Day Discharge With Hospital Readmission After Appendectomy in Pediatric Patients. JAMA Surg 2017; 152:1106.
27. CODA Collaborative, Davidson GH, Flum DR, et al. Antibiotics versus Appendectomy for Acute Appendicitis - Longer-Term Outcomes. N Engl J Med 2021; 385:2395.
28. Bhangu A, Søreide K, Di Saverio S, et al. Acute appendicitis: modern understanding of pathogenesis, diagnosis, and management. Lancet 2015; 386:1278.

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