Interval appendectomy-do we need to do it in current era?

Abstract

Background: Our current treatment of an appendiceal mass is initially conservative, followed by an interval appendectomy. The necessity of this routine interval appendectomy is debatable. Aim was to evaluate whether surgical factors and pathological features of the excised appendices support interval appendectomy. Methods: It was a retrospective study conducted for a period of 5 years (2017-2022). To assess the number of patients with appendicitis and a peri-appendiceal mass, all patients in both hospitals encoded for appendicitis were listed. Over this period of 5 years a total of 2,090 patients were diagnosed with acute appendicitis. Of these, 230 patients were operated through Interval appendectomy. All medical records of these patients were then reviewed and relevant variables were registered. Results: It was found that clinical findings alone were not specific enough to diagnose an appendiceal mass; 47% had a palpable abdominal mass and the median temperature was 38.2°C ranging from 36 to 40.5°C. Ultrasound examination was done in 70% of patients and showed an appendiceal mass in 72%. During the interval period, 4 patients presented with an appendiceal mass needing drainage, and 3 with acute appendicitis requiring emergency appendectomy. Conclusions: We conclude that when causes for the appendiceal mass other than appendicitis are excluded, interval appendectomy seems unnecessary in patients who respond well to initial conservative treatment.