FP7.4 - Interval appendicectomy: A single centre cohort Study

Abstract

Abstract Aims Interval appendicectomy occurs at a rate of < 15 %. It is recommended in non operative appendicitis (complicated appendicitis, appendix mass) to reduce recurrence. Acute appendicectomy rate was reduced in Covid 19 pandemic era, as aerosol generating procedures were deemed high risk. Interval appendicectomy can be offered after 6 weeks dependent on pre-requisite interval colorectal screening (colonoscopy or CT scan) prior to surgery. Aim of study is to assess the interval appendectomy at a single centre. Methods Cohort study carried out from Mar'2020 to Dec'2023. Descriptive demography & post-operative outcomes were evaluated for interval appendicectomy, and acute appendicectomy were used as controls. Results Interval appendicectomy (n = 45) Appendicectomy (n = 515) Mann Whitney U (p test) Age(yrs) 47.9 35.8 < 0.0001 Sex(M:F) 19 : 26 251 : 264 NS ASA(median) 2 1 NS BMI 26.5 25.5 NS WCC(x109/L) 6.5 13.2 < 0.0001 CRP(mg/L) 3.4 66.3 < 0.0001 Laparoscopic 45 507 Op time(mins) 74.4 74.9 NS Appendix length(mm) 55.7 66.6 < 0.0001 Appendix diameter(mm) 9.9 11.2 NS LOS(days) 0 2 < 0.0001 AB use(days) In-patient 0 ± 0.5 2 ± 1 < 0.0001 Post-op 0 ± 0 0 ± 2.5 Cost(£) 1046 4269 < 0.0005 Conclusion Interval appendicectomy is a safe and cost effective option in the management of appendix mass. Interval appendectomy allows resolution of acute appendicitis resulting in fewer intraoperative & postoperative complications. It reduces the chance of bowel resection & can be done as a day case procedure. However interval appendicectomy my require work-up prior to surgery.