Laparoscopic Surgery or Conservative Treatment for Appendiceal Abscess in Adults? A Randomized Controlled Trial

Annals of Surgery
Panu MentulaAri Leppäniemi

Abstract

We hypothesized that immediate laparoscopic surgery for appendiceal abscess would result in faster recovery than conservative treatment. On the basis of the retrospective studies, conservative management of appendiceal abscess is recommended as a first line treatment, but some controversy exists. Sixty adult patients diagnosed with appendiceal abscess were randomly assigned to either laparoscopic surgery (n = 30) or conservative treatment (n = 30). Hospital stay, recurrences, additional interventions, and complications within 60 days from randomization were recorded. There was no difference in hospital stay: 4 days (interquartile range: 3-5 days) in the laparoscopy group versus 5 days (3-8) in the conservative group, P = 0.105. Patients in the laparoscopy group had 10% risk for bowel resection and 13% risk for incomplete appendectomy. There were significantly fewer patients with unplanned readmissions in the laparoscopy group: 1 (3%) versus 8 (27%), P = 0.026. Additional interventions were required in 2 (7%) patients in the laparoscopy group (percutaneous drainage) and in 9 (30%) patients in the conservative group (surgery), P = 0.042. Recurrent abscesses and failure to respond to conservative treatment were the main reasons fo...Continue Reading

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Citations

Oct 27, 2015·American Journal of Surgery·Peter J FagenholzGeorge C Velmahos
Jul 21, 2016·World Journal of Emergency Surgery : WJES·Salomone Di SaverioRoland Andersson
Jan 24, 2019·International Journal of Colorectal Disease·S ShekarrizH Shekarriz
Mar 7, 2018·World Journal of Emergency Surgery : WJES·Hailan ZhangWeilin Wang
Apr 2, 2019·Surgical Infections·Patrick K McGillenSabrina E Sanchez
Aug 5, 2020·Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen·M AndricR Croner
Aug 16, 2016·Postgraduate Medical Journal·Ko-Chin ChenAndrew G Christy
Jan 25, 2019·Visceral Medicine·Peter BeckerDieter Schilling
Jun 9, 2019·International Journal of Colorectal Disease·J de JongeA A W van Geloven
Apr 17, 2020·World Journal of Emergency Surgery : WJES·Salomone Di SaverioFausto Catena
Sep 22, 2017·World Journal of Gastroenterology : WJG·Tomohide HoriTsunehiro Yoshimura
Dec 21, 2019·Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc·Erika HissongRhonda K Yantiss
Nov 5, 2017·Updates in Surgery·Gaetano PoillucciUNKNOWN ACTUAA-R Collaborative Working Group on Acute Appendicitis
Feb 4, 2021·Deutsches Ärzteblatt International·Patrick TéouleChristoph Reissfelder
May 18, 2021·Surgical Endoscopy·Stavros A AntoniouPer Olav Vandvik
Aug 14, 2021·GE Portuguese Journal of Gastroenterology·Ming Li ChiaVishal G Shelat
Nov 12, 2021·The Journal of Medical Investigation : JMI·Yuhei WakiMasayoshi Obatake

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