ACUTE APPENDICITIS: HISTORY AND CURRENT STATE OF THE MEDICAL CARE

Abstract

Introduction. The problem of diagnostics and treatment of an acute appendicitis, despite of comprehensive study of this issue, remains extremely actual that is caused by a high incidence of appendicitis, considerable number of various complications of this disease in the pre - and postoperative period. The objective of this study is to assess the current state and dynamics of indicators on acute surgical pathology of abdominal organs in St. Petersburg, scientific justification of the main trends in the development of surgical science and practice. Material and methods.Materials on monitoring of acute surgical pathology of abdominal organs in St. Petersburg are presented to one of 7 nosological forms in the article, – an acute appendicitis. Historical-analytical, standard- legal and statistical methods were used. Results. A decrease in the proportion of patients with acute appendicitis in the structure of 7 nosological forms of acute surgical pathology of the abdominal organs, united in the concept of «acute abdomen» (by 64.18 %: from 91.93 % in 1953 to 27.75 % in 2016); a decrease in the number of operated patients by 67.9 %; an increase in operational activity to 98.28 % in 2016; an increase in the proportion of patients with hospitalization for less than 24 hours from 58.13 % (1932-1946) to 66.74 % (1953-2016); the rate of late hospitalization (later than 24 hours) remains almost stable for the entire period of observation (more than 60 years), and in recent years has even a slight increase (+8.21%). There is a decrease in postoperative mortality in acute appendicitis in 350 times (from 21.00% in 1910 to 0.06% in 2016).Conclusion. The work demonstrates the success of healthcare in the field of emergency surgery, which are due to many factors to improve organizational approaches related to the development of diagnosis and treatment of acute appendicitis, including – description of characteristic symptoms, introduction of laboratory diagnostics, study of atypical and complicated clinical forms, peculiarities of the disease course in children and elderly people, definition of the terms of surgical intervention, introduction into clinical practice and improvement of instrumental methods of diagnostics and endosurgical methods of appendectomy, etc.