Pata, FrancescoDi Martino, MarcelloPodda, MauroDi Saverio, SalomoneIelpo, BenedettoPellino, GianlucaACIE Appy Study Collaborative2023-01-102023-01-102022Pata F, Di Martino M, Podda M, Di Saverio S, Ielpo B, Pellino G, et al. Evolving trends in the management of acute appendicitis during COVID-19 waves: the ACIE Appy II Study. World J Surg. 2022 Sep;46(9):2021-2035. DOI: 10.1007/s00268-022-06649-z0364-2313http://hdl.handle.net/10230/55247Background: in 2020, ACIE Appy study showed that COVID-19 pandemic heavily affected the management of patients with acute appendicitis (AA) worldwide, with an increased rate of non-operative management (NOM) strategies and a trend toward open surgery due to concern of virus transmission by laparoscopy and controversial recommendations on this issue. The aim of this study was to survey again the same group of surgeons to assess if any difference in management attitudes of AA had occurred in the later stages of the outbreak. Methods: from August 15 to September 30, 2021, an online questionnaire was sent to all 709 participants of the ACIE Appy study. The questionnaire included questions on personal protective equipment (PPE), local policies and screening for SARS-CoV-2 infection, NOM, surgical approach and disease presentations in 2021. The results were compared with the results from the previous study. Results: a total of 476 answers were collected (response rate 67.1%). Screening policies were significatively improved with most patients screened regardless of symptoms (89.5% vs. 37.4%) with PCR and antigenic test as the preferred test (74.1% vs. 26.3%). More patients tested positive before surgery and commercial systems were the preferred ones to filter smoke plumes during laparoscopy. Laparoscopic appendicectomy was the first option in the treatment of AA, with a declined use of NOM. Conclusion: management of AA has improved in the last waves of pandemic. Increased evidence regarding SARS-COV-2 infection along with a timely healthcare systems response has been translated into tailored attitudes and a better care for patients with AA worldwide.application/pdfengCopyright © Pata F, Di Martino M, Podda M, Di Saverio S, Ielpo B, Pellino G, 2022, corrected publication 2022. Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.ApendicitisCOVID-19 (Malaltia)Pandèmia de COVID-19, 2020-Cirurgiainfo:eu-repo/semantics/articlehttp://dx.doi.org/10.1007/s00268-022-06649-zinfo:eu-repo/semantics/openAccess