Right Iliac Fossa Treatment Audit
 

Photo credit: tornatore via Foter.com / CC BY-SA

There is significant variation in the management of patients with right iliac fossa (RIF) pain. Whilst laparoscopy has become first line in many units, the 2012 UK National Appendicectomy Audit identified that a third of appendicectomies at that time were being performed using an open approach. The results of this study were widely presented at local units and national meetings as well as being published in several journals.

New guidelines published by the World Society of Emergency Surgery (WSES) in 2016 and the alternative European Association of Endoscopic Surgeons (EAES, 2015) provide an opportunity to close the loop on the 2012 audit and to re-audit the modern management of RIF pain.

The primary aim of this audit is to determine the laparoscopic appendicectomy rate in 2017. The secondary aim is to audit the normal appendicectomy rate. Variation in centres’ case mix may influence the normal appendicectomy rate. Patients can be stratified into low, medium, and high risk for appendicitis using the Alvarado or Appendicitis Inflammatory Response (AIR) scores. Baseline variation will be addressed by adjustment using risk scoring.

Key Points

  • Two data collection periods of two weeks each
  • An optional third data collection period
  • All surgical trainees welcomes
  • This a re-audit and very useful for CVs and interviews

Protocol

LSRG Registered Collaborators

Total collaborators = 167 | Audit registered = 82%

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Hospital
Name
Grade
Audit Registered
Local Lead
Barnet Hospital
James Haddow
ST3+
yes
Barnet Hospital
Scarlet Nazarian
CT
yes
Local lead
Barnet Hospital
Nicholas Symons
ST3+
yes
Basildon
Ines Silva
FY
yes
Local lead
Basildon
Grigory Pankin
Med Student
yes
Basildon
Beghal Gurpreet
Med Student
yes
Basildon hospital
Hirel patel
FY
yes
Basildon Hospital
Adam Misky
FY
yes
Basildon Hospital
Nadeem Ashraf
Consultant
yes
Basildon Hospital
Andrew Busuttil
ST3+
yes
Broomfield hospital
Osamah Niaz
CT
yes
Local lead
Charing Cross
Michalis Charalambous
ST3+
Local lead
Chelsea & Westminster Hospital
K.Yeung
ST3+
Local lead
Chelsea and Westminster Hospital
George Malietzis
ST3+
Conquest and Eastbourne Hospital
Anthony Thaventhiran
ST3+
yes
Local lead
Conquest Hospital, St Leonards on Sea
D.Jenner
Consultant
yes
Croydon Hospital
Amelia Martin
Med Student
yes
Croydon Hospital
David Du
FY
yes
Croydon Hospital
Jessica Tan
CT
yes
Croydon Hospital
Paul Dent
ST3+
yes
Croydon University Hospital
Nigel D'Souza
ST3+
yes
Croydon University Hospital
Georgina Hicks
CT
yes
Local Lead
Darent Valley Hospital
Nazrin Assaf
CT
yes
Local lead
Dorset County Hospital
Zara Hayat
CT
Local lead
E.Tan@hotmail.co.uk
Lizzy Tan
FY
Epsom & St Helier
Dr Mark Oakey
FY
yes
Epsom and St Helier NHS trust
Michael Murray
FY
yes
Local lead
Frimley Park Hospital
Lalit
ST3+
Local lead
Homerton
K. Theodoropoulou
ST3+
yes
Homerton Hospital
Pedro Cunha
ST3+
yes
Homerton Hospital
Dardan Popova
FY
yes
Homerton Hospital
Mary Venn
ST3+
yes
Local lead
Homerton Hospital
Abdul Quddus
Consultant
yes
Homerton University Hospital
Sarantos Kaptanis
ST3+
yes
Homerton University Hospital
samuel dafydd rigby
FY
yes
Homerton University Hospital
Swathi Rajagopal
FY
King George Hospital, Ilford
Sujay Shah
ST3+
yes
Local lead
King George Hospital, Ilford
Louise Murchison
CT
yes
King George Hospital, Ilford
James Graveston
CT
yes
King George Hospital, Ilford
Ed Balai
FY
yes
King George Hospital, Ilford
Aman Bhargava
Consultant
yes
King's College Hospital
Mili
FY
yes
King's College Hospital
Daniel Nash
FY
yes
kings college hospital
inez eiben
FY
yes
Local Lead
Kingston
Jane Turner
ST3+
yes
Kingston Hospital
Vera Tudyka
Consultant
yes
Kingston Hospital
Monika Rezacova
CT
yes
Local lead
Leicester Royal Infirmary
Hilary West
ST3+
yes
Local lead
Lister Hosital, Stevenage
Emily Farrow
FY
yes
Local lead
Lister Hospital, Stevanage
Andrew Barrie
FY
yes
Lister Hospital, Stevenage
Geraint Lloyd
Consultant
yes
Lister Hospital, Stevenage
Kathryn Kumar
FY
yes
Lister Hospital, Stevenage
Anoushka Neale
FY
yes
Lister Hospital, Stevenage
Dilek Taze
FY
yes
Lister Hospital, Stevenage
Siya Lodhia
FY
yes
Maidstone and Tunbridge Wells NHS Trust
Muhammad Rafaih Iqbal
ST3+
yes
Local lead
Medway Maritime Hospital
Constantine Halkias
ST3+
yes
Local lead
Medway Maritime Hospital
Evangelia Iosif
CT
yes
North Middelsex University Hospital
Manoj Nair
Consultant
yes
North Middlesex University Hospital
Martin Connor
CT
yes
North Middlesex University Hospital
Rory Callan
FY
yes
Local lead
North Middlesex University Hospital
Subramaniam Guru Naidu
ST3+
yes
Northwick Park
Josef Watfah
Consultant
yes
Northwick Park Hospital
Kapil Sahnan
ST3+
yes
Northwick Park Hospital
Samuel Adegbola
ST3+
yes
Local lead
Northwick Park Hospital
Amish Acharya
CT
yes
Northwick Park Hospital
Abhiney Jain
CT
yes
Princess Royal University Hospital
Rehana Hafeez
ST3+
yes
Local lead
Princess Royal University Hospital, Orpington
Tarun Singhal
Consultant
yes
Queen Elizabeth Hospital, London
Midhat Siddiqui
Consultant
Queen Elizabeth Hospital, London
Imran Chishti
ST3+
Queen Elizabeth Hospital, London
Julio Ayube-Brown
CT
Queen Elizabeth Hospital, London
Zain Siddiqui
FY
Queen Elizabeth Hospital, Woolwich
Victor Kung
ST3+
yes
Local lead
Queen Elizabeth Hospital, Woolwich
Joshua Tognarelli
FY
Queen Elizabeth Hospital, Woolwich
Ashiv Patel
FY
Queen Elizabeth Hospital, Woolwich
Beth Springate
FY
Queen Elizabeth Hospital, Woolwich
Wenona Barnieh
FY
Queen Elizabeth the Queen Mother Hospital
Mohamed A Rabie
ST3+
yes
Local lead
Queen Elizabeth the Queen Mother Hospital
Eda Yardimci
Med Student
yes
Queen Elizabeth the Queen Mother Hospital
Poonam Jani
FY
yes
Queen Elizabeth the Queen Mother Hospital
Laura Blake
CT
yes
Queen Elizabeth the Queen Mother Hospital
Sathyan Nagendram
CT
yes
Queen Elizabeth the Queen Mother Hospital
Mohamed Boshnaq
ST3+
yes
Queens Hospital (Romford)
Shawmian Singagireson
FY
yes
Local lead
Royal Free Hospital
Massimo Varcada
Consultant
yes
Royal Free Hospital
David Peprah
Med Student
yes
Royal Free Hospital
Angus Hann
ST3+
yes
Local lead
Royal London hospital
Maryam Alfa-Wali
ST3+
yes
Royal London Hospital
Mohamed A Thaha
Consultant
Royal London Hospital
Arti Garg
ST3+
Local lead
Royal London Hospital
Ibnauf Suliman
ST3+
Royal London Hospital
Sadek Shahriar
ST3+
Royal London Hospital
Zara Al-Faham
FY
Royal London Hospital
Alpa Morawala
CT
Royal London Hospital
William English
CT
Royal London Hospital
Tom Abbott
CT
Royal London Hospital
Alexandra Osterberg
FY
Royal Sussex County Hospital
James Cohen
FY
yes
Local lead
Royal Sussex County Hospital, Brighton
Saad Rehman
CT
yes
Southampton General Hospital
Karan Rangarajan
CT
yes
Local lead
St Helier
Edwin Evelyn-Rahr
FY
yes
St Helier
Hannah Smoker
FY
yes
St Helier Hospital
Dr Claire Nichols
FY
yes
Local lead
St Helier Hospital
Thomas Hall
FY
yes
St Mary's Hospital
Rebecca Mersh
CT
yes
Local lead
St Mary's Hospital, Paddington
James Kinross
Consultant
yes
St Mary's Hospital, Paddington
Andrea Frilling
Consultant
yes
St Peter's Hospital, Chertsey
Richard Newton
ST3+
yes
Local lead
St Thomas'
Dr Guy Stephens
FY
yes
Local lead
St Thomas' Hospital
Amita Khasria
Med Student
yes
St Thomas' Hospital
Rahul Bagga
Med Student
yes
St Thomas' Hospital
Sarah Wheatstone
Consultant
yes
St Thomas' Hospital
james Gossage
Consultant
yes
St Thomas' Hospital
Pan Yidong
Med Student
St Thomas' Hospital
Nipun Mundkur
Med Student
St Thomas' Hospital
Dema Motter
Med Student
St. George'Street Hospital, Tooting
Delia Toomey
CT
yes
Local lead
St. George'Street Hospital, Tooting
Alex Rosinson
CT
yes
St. George'Street Hospital, Tooting
Ben Miller
CT
yes
St. George'Street Hospital, Tooting
Christina Fontaine
CT
yes
St. George'Street Hospital, Tooting
Rowland Storey
ST3+
yes
St. George'Street Hospital, Tooting
Rowland Storey
ST3+
yes
St. George'Street Hospital, Tooting
Nikhil Ladwa
ST3+
yes
St. Mary's Hospital
Lisa Amani
Med Student
yes
The Whittington
Alexandra Kate Scholey
Med Student
yes
University College London Hospital
Sara Renshaw
CT
yes
University College London Hospital
Bibek Das
CT
yes
University College London Hospital
Danielle Franklin
FY
yes
Local lead
University College London Hospital
Joseph Davidson
CT
yes
University College London Hospital
Uma Walters
FY
yes
Watford General Hospital
Dominic Townsend
FY
yes
Watford General Hospital
Walid Osama Mohamed
FY
yes
Watford General Hospital
Britain Baker
FY
yes
Local lead
Watford General Hospital
Oliver Blackford
FY
yes
Watford General Hospital
James wakelam
CT
yes
Watford General Hospital
Sophie Bond
FY
yes
Watford General Hospital
Kajaluxy Ananthan
FY
yes
West Middlesex Hospital
Rebekah Williams
FY
yes
West Middlesex Hospital
Jack Garnham
FY
yes
West Middlesex Hospital
Henry Robb
FY
yes
West Middlesex Hospital
Jonathan Allington
FY
yes
West Middlesex Hospital
Louise Cloney
FY
yes
West Middlesex Hospital
Euan Strachan
FY
yes
West Middlesex University Hospital
Bubby Thava
Consultant
yes
West Middlesex University Hospital
Bhavik Patel
FY
yes
Local lead
Weston general Hospital
Chiara Rossi
ST3+
Wexford General
Helen Earley
CT
yes
Wexford general hospital
Fiona Nolan
CT
yes
Wexford general hospital Ireland
Badreldin mohamed elbagir
CT
yes
Wexford General Hospital, Ireland.
Abdul Ahad
ST3+
yes
Local lead
Whipps Cross Hospital
Jia Choong
FY
Local lead
Whittington
Emily norman
FY
yes
Whittington
Samir Sahey
Med Student
yes
Whittington
Samuel Gunning
Med Student
yes
Whittington
Esther Nimako
Med Student
yes
Whittington
Darshni Pandya
Med Student
yes
Whittington Hospital
Tahira Mohamed
Med Student
yes
Local lead
Whittington Hospital
Bryony Peiris
Med Student
yes
William Harvey Hospital
Nathan Hudson-Peacock
FY
yes
Local lead
William Harvey Hospital
Pennylouise Hever
FY
yes
William Harvey Hospital
Mustafa Al-sheikh
ST3+
yes
William Harvey Hospital
Caterina Clements
CT
yes
William Harvey Hospital
Amar Amayo
FY
yes
William Harvey Hospital
Rose Hartzenberg
FY
yes
William Harvey Hospital
Charles Bull
ST3+
yes
Worthing Hospital
Madhusoodhana Hebbar
ST3+
yes
Local lead

West Midlands Research Collaborative