Speaker: 泌尿科R1陳柏仲 Advisor: 一般外VS郭威廷

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1 Speaker: 泌尿科R1陳柏仲 Advisor: 一般外VS郭威廷
EBM discussion Speaker: 泌尿科R1陳柏仲 Advisor: 一般外VS郭威廷

2 題目

3 Q1.闌尾炎真的要開刀嗎？光是吃藥打針不會好嗎？
P: patient with appendicitis I: surgical intervention C: medical treatment O: survival rate、disease-free rate

4 Search Strategy Key word: appendicitis、appendectomy、medical treatment、antibiotics、supportive care…etc. Search web: PubMed, Medline, Cochrane,

5 Key word: appendicitis Search web: the Cochrane library
We want！

6 Key word: appendicitis Search web: PubMed

7 Key word: appendicitis, antibiotics Search web: PubMed
We want！

8 READING…………. READING…………. READING………….

9 Results of Cochrane

10

11 Explain the Q1 by Cochrane data

12 Explain the Q1 by Cochrane data

13 Explain the Q1 by Cochrane data
Non-inferiority analyses

14 Results of Pubmed

15 Antibiotics: complication rate↓ Appendectomy: recurrance rate↓

16 Conclusion of Q1 Q1.闌尾炎真的要開刀嗎？光是吃藥打針不會好嗎？
目前現階段的研究並無法確定單用Antibotics及Appendectomy兩者哪個比較好，但就以兩個月內康復及一年不復發的比例來說，Appendectomy較優；但Antibiotics較少Complication rate.

17 Q2.闌尾炎破掉形成濃瘍，是不是保守治療比直接進去開刀還要好？
P: patient with perforating appendicitis I: surgical immediately C: conservative treatment than delay surgery O: survival rate、disease-free rate

18 Search Strategy Key word: appendicitis、appendectomy、early、delay、abscess…etc Search web: PubMed, Medline, Cochrane, NGC

19 Switch the Key word for several times…………….

20 Key word: appendectomy Search web: the Cochrane library

21

22

23 Conclusion of Q2 Q2.闌尾炎破掉形成濃瘍，是不是保守治療比直接進去開刀還要好？
目前並無Level 1A的study。但有Level 2A的study。結論是：複雜性闌尾炎在兩者個治療方式上，住院天數、抗生素使用日數並無顯著差異。 但在腸阻塞、再次手術、感染、濃瘍形成的比例上來說，直接開刀進去的風險較高。

24 Thanks for attention~~~