Abstract
Background: For more than 100 years, surgeons have been successfully performing appendectomy to treat acute appendicitis. However; there is recent trend to shift towards a more conservative approach. This work aimed to assess the non- operative management in the treatment of acute uncomplicated appendicitis. Methods: One hundred and sixteen patients with uncomplicated acute appendicitis were enrolled into the study. They were divided into two groups (Group A & Group B). Patients in Group A were subjected to non-operative management with antibiotics while patients in Group B were subjected to appendectomy. All patients were evaluated at hospital discharge, at 30-days and at a median follow-up on year. The primary outcome was the success rate of the non-operative management. Secondary outcomes were the difference of length of hospitalization, time to return to normal activity, and quality-of-life measures between both groups. Results: The success rate of non-operative strategy was 93.3% (42 of 45) at hospital discharge, 88.8% (40 of 45) at 30-days and 82.2% (37 of 45) at a median follow-up of one year. Patients in Group A have a significantly shorter time to return to normal activities. They reported higher quality of life scores. The length of hospitalization was significantly shorter in Group B. Conclusion: Giving intravenous antibiotics to some patients with uncomplicated acute appendicitis instead of having them undergo surgery may be safe and effective.
Highlights
Surgeons remove the appendix to treat acute appendicitis since the late of 1800s, even though an inflamed appendix sometimes gets better on its own
The greatest advance of antibiotic production and success of discovery of newly highly effective broad-spectrum antibiotics allow for more conservative approach in management of such cases [14]
Several recent European randomized controlled trials suggest that therapy with antibiotics alone is a safe treatment option for appendicitis
Summary
Surgeons remove the appendix to treat acute appendicitis since the late of 1800s, even though an inflamed appendix sometimes gets better on its own. Methods: One hundred and sixteen patients with uncomplicated acute appendicitis were enrolled into the study. Secondary outcomes were the difference of length of hospitalization, time to return to normal activity, and quality-of-life measures between both groups. Results: The success rate of non-operative strategy was 93.3% (42 of 45) at hospital discharge, 88.8% (40 of 45) at 30-days and 82.2% (37 of 45) at a median follow-up of one year. Patients in Group A have a significantly shorter time to return to normal activities. They reported higher quality of life scores. Conclusion: Giving intravenous antibiotics to some patients with uncomplicated acute appendicitis instead of having them undergo surgery may be safe and effective
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