Is interval appendectomy really needed? A closer look at neoplasm rates in adult patients undergoing interval appendectomy after complicated appendicitis.

Surgical Endoscopy
Danielle HayesRyan Martinez

Abstract

The treatment algorithm for appendicitis is evolving, with recent interest in non-operative management. However, the safety of non-operative management for patients with complicated appendicitis has been questioned due to concern for increased risk of occult appendiceal neoplasm in this patient population. Our study aims to determine the rate of neoplasms discovered during interval appendectomy for patients with complicated appendicitis and determine the necessity of interval appendectomy. A retrospective chart review was conducted on interval appendectomies performed in adult patients for complicated appendicitis at our institution over a 9-year period. Interval appendectomy was defined as appendectomy delayed from initial presentation with appendicitis. Complicated appendicitis was defined as perforation, phlegmon, and/or abscess as seen on computed tomography at time of presentation. We identified 402 patients who underwent interval appendectomy for complicated appendicitis. A total of 36 appendiceal neoplasms were discovered on final pathology with an overall neoplasm rate of 9%. Patients with an appendiceal neoplasm were significantly older (56.6 years vs 45.1 years, p < 0.01). No patients under the age of 30 had a neoplas...Continue Reading

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Citations

Feb 19, 2021·World Journal of Surgery·Dimitrios K ManatakisEvaghelos Xynos
May 11, 2021·The British Journal of Surgery·R PeltriniF Corcione

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