Clinical Health Service Research on the Surgical Therapy of XXXX : Comparison of Outcomes Based on 3 German Multicenter Quality Assurance Studies Over 21 Years.

@entity1 @entity32 @entity697 @entity1538 @entity698 @entity6177
OBJECTIVE:: The treatment of @entity697 has seen changes in diagnosis and therapy in Germany. The objective of this analysis was to assess changes in therapy and outcome after @entity1538 ( @entity1538 ) and laparoscopic appendectomy (LA) over the last 21 years. BACKGROUND:: The analysis was based on 3 prospective multicenter quality assurance studies conducted by the Institute for Quality Control in Operative Medicine of the University of Magdeburg. METHODS:: All inpatients with a diagnosis of @entity698 in these studies (1988/1989, 1996/1997, 2008/2009) were included. Multiple linear and logistic regression analyses were performed. Statistical significance was set at P < 0.05. RESULTS:: Data from 17,732 treatments of @entity1 diagnosed with @entity698 were collected. The average age of @entity1 increased between the 3 studies from 25.7 to 34.6 years (P < 0.001). The preoperative selection of LA or @entity1538 was based on American Society of Anesthesiologists' classification (P < 0.001). Between 1996/1997 and 2008/2009, the share of LA climbed from 33.1% to 85.8% (P < 0.001). In the study from 2008 to 2009, LA showed a significant advantage over the conventional technique in wound healing disturbances (P < 0.001) and the clinical duration of stay (P < 0.001). At no stage of @entity32 did LA significantly increase @entity6177 . The use of a stapler is currently the most common method of appendiceal stump closure (83.6%). CONCLUSIONS:: Changes in @entity1 data reflected demographic changes. Preoperative selection leads to 2 clearly defined groups. LA is the most dominant method of current operative therapy. The negative selection in @entity1538 group has influenced the worse outcome of that group.
