Laparoscopic appendectomy vs antibiotic therapy for acute appendicitis: a propensity score-matched analysis from a multicenter cohort study

Updates in Surgery
Gaetano PoillucciACTUAA-R Collaborative Working Group on Acute Appendicitis

Abstract

Acute appendicitis (AA) is among the most common causes of acute lower abdominal pain leading patients to the emergency department. Significant debate remains on whether AA should be operated or not. A propensity score-matched analysis was performed in seven Italian Hospitals, with the aim to assess safety and feasibility both nonoperative management with antibiotics (AT) and surgical therapy with appendectomy (ST) for patients with AA. Data regarding all patients discharged from the participating centers with a diagnosis of appendicitis from January 1st, 2014 to December 31st, 2014 were collected retrospectively. Follow-up data were collected from January 1st, 2015 to December 31st, 2016. The complication-free treatment success of AT (53.7%) was significantly inferior to that of ST (86.4%) (P < 0.0001). Patients initially treated with antibiotics reported an index admission AT failure rate of 20.9% and a recurrence rate at 1-year follow-up of 20.3%. No statistically significant difference was found when comparing AT and ST groups for the outcome of interest post-operative complications (13.5 vs 13.6%, P = 0.834). Patients treated with AT were discharged home earlier than patients in the ST group (3.38 ± 1.89 vs 4.84 ± 2.69 day...Continue Reading

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Citations

Oct 28, 2018·Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen·S Schölch, C Reißfelder
Jan 18, 2019·World Journal of Emergency Surgery : WJES·Salma Abu FoulAhmad Mahajna
Apr 30, 2020·Praxis·Nickolaus Heeren, Markus Gass
Jul 17, 2019·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Gaetano PoillucciUNKNOWN ERASO (Elderly Risk Assessment And Surgical Outcome) Collaborative Study Group
Jan 10, 2021·Langenbeck's Archives of Surgery·Franziska KöhlerArmin Wiegering

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