Efficiency and efficacy in the treatment of appendicitis

The first part focuses on the diagnosis and treatment of acute appendicitis in The Netherlands.
Chapter 2 describes current surgical treatment and outcome of appendicitis in the Netherlands for adult patients, results from the snapshot study. Chapter 3 describes the diagnosis, treatment and outcome of children with acute appendicitis from the same cohort. Chapter 4 elaborates on the important role of pre-operative imaging in the work up of suspected appendicitis and the difference between the United Kingdom and The Netherlands.
The second part focusses on the role of imaging and timing in the work up of acute and possible complicated appendicitis.
Chapter 5 describes the consequences of delaying surgery longer than 8 hours in acute appendicitis with a focus on the difference between complicated and uncomplicated appendicitis. Chapter 6 is a systematic review and meta-analysis of diagnostic accuracy of imaging modalities, ultrasound, CT and MRI, in discriminating complicated from uncomplicated acute appendicitis. Chapter 7 describes the diagnostic accuracy of imaging modalities, ultrasound, CT, MRI or a combination in daily practice to discriminate between complicated and uncomplicated acute appendicitis.
The third part focuses on the consequences of histological evaluation in the treatment of appendicitis.
Chapter 8 describes incidence of appendicular neoplasms in patients operated for acute appendicitis and focuses on the consequences and outcome of additional treatment. Chapter 9 describes risk factors for an interval appendectomy in patients who were initially managed non-operatively for an appendicular mass. A special focus after interval appendectomy is given to the incidence of appendicular neoplasms. Chapter 10 explores the correlation between intra-operative evaluation of the appendix and postoperative histological evaluation and consequences for clinical outcome.