Conservative Treatment Versus Appendectomy for Acute Uncomplicated Appendicitis

Abstract

Background: For more than 100 years, surgeons have been successfully performing appendectomy to treat acute appendicitis. However; there is recent trend to shift towards a more conservative approach. This work aimed to assess the nonoperative management in the treatment of acute uncomplicated appendicitis. Methods: One hundred and sixteen patients with uncomplicated acute appendicitis were enrolled into the study. They were divided into two groups (Group A & Group B). Patients in Group A were subjected to non-operative management with antibiotics while patients in Group B were subjected to appendectomy. All patients were evaluated at hospital discharge, at 30-days and at a median follow-up on year. The primary outcome was the success rate of the non-operative management. Secondary outcomes were the difference of length of hospitalization, time to return to normal activity, and quality-of-life measures between both groups. Results: The success rate of non-operative strategy was 93.3% (42 of 45) at hospital discharge, 88.8% (40 of 45) at 30-days and 82.2% (37 of 45) at a median follow-up of one year. Patients in Group A have a significantly shorter time to return to normal activities. They reported higher quality of life scores. The length of hospitalization was significantly shorter in Group B. Conclusion: Giving intravenous antibiotics to some patients with uncomplicated acute appendicitis instead of having them undergo surgery may be safe and effective.