Our Summary

The research paper talks about a case of a 45-year-old man with serious kidney disease who was undergoing peritoneal dialysis (PD), a treatment that uses the lining of your abdomen to filter your blood. He arrived at the hospital with severe stomach pain and fever. Initially, doctors suspected peritonitis (inflammation of the abdominal lining) which is often associated with patients on PD. However, a CT scan revealed that he had appendicitis (inflammation of the appendix).

The doctors performed a laparoscopic appendectomy, a minimally invasive surgery to remove the appendix, and managed to preserve the PD catheter. Although the patient had a good kidney function post-surgery, his blood tests showed he needed to continue with his dialysis treatment.

Therefore, just two days after the surgery, doctors resumed his PD treatment, but with a lower volume of fluid and in a lying-down position. The patient didn’t have any complications from this and was able to go home on the fourth day after surgery.

The study concludes that in certain cases, it’s possible to resume PD treatment early after laparoscopic surgery. However, it’s crucial that the dialysis team closely monitor the patient for any complications.

FAQs

  1. What is a laparoscopic appendectomy and why is it used in this case?
  2. Is it possible to resume peritoneal dialysis treatment shortly after a laparoscopic appendectomy?
  3. What precautions need to be taken when resuming peritoneal dialysis treatment after laparoscopic surgery?

Doctor’s Tip

A helpful tip a doctor might tell a patient about laparoscopic appendectomy is to follow post-operative care instructions carefully, including avoiding heavy lifting or strenuous activity for a certain period of time, taking prescribed medications as directed, and attending follow-up appointments with your healthcare provider. It’s also important to listen to your body and report any unusual symptoms or concerns to your doctor promptly.

Suitable For

Patients who are recommended for laparoscopic appendectomy typically include those with uncomplicated appendicitis, meaning the appendix is inflamed but has not ruptured or formed an abscess. Laparoscopic appendectomy is preferred over open surgery for patients who are otherwise healthy and have a lower risk of complications.

In the case mentioned above, the patient’s serious kidney disease and need for peritoneal dialysis added complexity to the situation. However, with careful monitoring and management by the healthcare team, the patient was able to undergo successful surgery and resume dialysis treatment shortly after.

Overall, laparoscopic appendectomy is a safe and effective treatment option for most patients with uncomplicated appendicitis, but individual factors such as underlying health conditions may influence the decision-making process. It’s important for healthcare providers to assess each patient’s unique situation and tailor their treatment plan accordingly.

Timeline

Before laparoscopic appendectomy:

  • Patient experiences severe stomach pain and fever
  • Initial suspicion of peritonitis
  • CT scan reveals appendicitis

After laparoscopic appendectomy:

  • Surgery is performed to remove the appendix
  • PD catheter is preserved during surgery
  • Patient’s kidney function is good post-surgery
  • Resumption of PD treatment two days after surgery with lower fluid volume and lying-down position
  • Patient goes home on the fourth day after surgery
  • Close monitoring by dialysis team for any complications

What to Ask Your Doctor

  1. What is a laparoscopic appendectomy and how is it different from traditional open surgery?

  2. How long will the surgery take and what is the recovery time?

  3. Will I need to stay in the hospital after the surgery and if so, for how long?

  4. How soon can I resume normal activities, including work and exercise?

  5. Are there any potential risks or complications associated with a laparoscopic appendectomy?

  6. Will I need any follow-up appointments after the surgery?

  7. How will the surgery affect my kidney disease and peritoneal dialysis treatment?

  8. Will I need to make any changes to my dialysis treatment plan after the surgery?

  9. How will the surgery impact my overall kidney function and health in the long term?

  10. What symptoms should I watch out for after the surgery that may indicate a complication?

Reference

Authors: Golsorkhi M, Ganesan L, Infante S, Abdipour A. Journal: J Investig Med High Impact Case Rep. 2023 Jan-Dec;11:23247096231158957. doi: 10.1177/23247096231158957. PMID: 37056199