Abstract
Appendicectomy has been the gold standard treatment of acute appendicitis for more than a century, while nonoperative therapies, including antibiotics, have acquired increased interest in recent years. The present meta-analysis aimed to compare the therapeutic effects of antibiotics versus appendicectomy for the treatment of acute appendicitis. Medline, Embase and The Cochrane Library databases were searched. Prospective randomized controlled trials that compared antibiotic treatment with surgery were included. The outcomes evaluated included the time of hospital stay, complications and time to work. There were no statistically significant differences between the antibiotic and appendicectomy groups with regard to the time of hospital stay and complications. However, the time to work was significantly longer in the appendicectomy group when compared with the antibiotic group. In addition, the therapeutic effects of antibiotics and appendicectomy were comparable for the treatment of acute appendicitis.
Highlights
Acute appendicitis is the most common etiology of acute abdomen [1]
Appendicectomy has been regarded as the gold standard for acute appendicitis for more than a century
The present meta-analysis evaluated the therapeutic effects of antibiotics and appendicectomy for the treatment of acute appendicitis
Summary
Acute appendicitis is the most common etiology of acute abdomen [1]. Appendicectomy has been the predominant treatment of acute appendicitis for more than a century since being introduced by McBurney in the 1880's and being performed by Grooves in 1883. As a classic surgical procedure, open appendicectomy is considered to be safe and effective surgery for acute appendicitis that avoids perforation. It is the gold standard treatment of appendicitis. Nonoperative treatment has played a minor role in treating acute appendicitis. Antibiotic therapy, the main nonoperative therapy, is becoming increasingly important in the treatment of acute appendicitis [9,10]. Previous studies have shown that perforated appendicitis in children may be treated with antibiotics [11,12,13]. The aim of the present meta-analysis was to compare antibiotic and appendicectomy treatment for acute appendicitis in cases where surgeons were not limited by technical constraints
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