Endoscopic retrograde appendicitis techniques for the treatment of patients with acute appendicitis

Ye, Liping; Mao, Xin-Li; Yang, Hai; He, Bili; Zhu, Lin-Hong

doi:10.1055/a-0581-9119

Cited by 18 publications

(16 citation statements)

References 16 publications

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“…Finally, as first preliminary data on endoscopic treatment of acute appendicitis is published, maybe conservative treatment will be further improved by combining antibiotic treatment with endoscopic drainage of the appendiceal lumen by a stent [40,41]. …”

Section: Discussionmentioning

confidence: 99%

Clinical Management of Appendicitis

2018

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Background: Ever since the first appendectomy has been performed, surgery has been the standard of care for acute appendicitis, with antibiotic therapy being reserved for special situations. Recent studies have shown the feasibility of antibiotic therapy for uncomplicated appendicitis. Methods: This clinical therapeutic review is based both on author expertise and a selective literature survey in PubMed based on the term ‘appendicitis', combined with the terms ‘acute', ‘complicated', ‘conservative', ‘non-operative', ‘therapy', ‘surgery', and ‘strategy'. According to these search results as well as to the treatment guidelines from the American College of Surgeons, Society for Surgery of the Alimentary Tract, Society of American Gastrointestinal and Endoscopic Surgeons, European Association of Endoscopic Surgery, and World Society of Emergency Surgery, we present an interdisciplinary treatment concept. Results: Approximately 90% of patients treated with antibiotics are able to avoid surgery during the initial admission. The other 10% that fail to respond to antibiotics require a rescue appendectomy. Recurrence rates of non-operated patients within 1 year are as high as 20-30%. Conclusion: In uncomplicated appendicitis without risk factors for failure of non-operative management, a shared decision based on the patient's preferences should be made. In cases with risk factors, appendectomy is still the treatment recommended. If the diagnosis is uncertain or clinical symptoms are rather mild, antibiotic therapy should be started. In complicated appendicitis, management depends on the clinical state, with either immediate surgery or primarily antibiotic therapy and combined with drainage of abscess, being followed by interval appendectomy in some cases.

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Section: Discussionmentioning

confidence: 99%

Clinical Management of Appendicitis

2018

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“…There is no gold standard for the preoperative diagnosis of appendicitis and the clinical manifestations (e.g., Alvarado score) are still used for the diagnosis. In recent years, a retrospective study and analysis showed that using endoscopy with appendiceal cavity imaging to observe the internal orifice and surrounding mucosa of the appendix along with data obtained by X-ray or ultrasound can accurately diagnose acute appendicitis [2][3]11]. Even with the progress of endoscopic technology, there is still little evidence that appendiceal cavity imaging can accurately exclude appendix disease.…”

Section: Discussionmentioning

confidence: 99%

“…They underwent ultrasound followed by colonoscopy with digital single-operator cholangioscopeassisted ERAT upon confirmation. 2 Follow-up was by telephone call, which all patients answered. ▶…”

Section: Patients N 14mentioning

confidence: 99%

“…Acute appendicitis is the most common abdominal emergency occurs in all age groups. Endoscopic retrograde appendicitis therapy (ERAT) is a new and minimally invasive alternative method for the diagnosis and treatment of acute appendicitis [1,2] whose effectiveness has been confirmed in a multicenter retrospective trial [3]. The technique has required endoscopic direct-vision imaging or fluoroscopic endoscopic retrograde appendicography to separate suspected acute appendicitis from actual acute appendicitis.…”

Section: Introductionmentioning

confidence: 99%

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Digital single-operator cholangioscope for endoscopic retrograde appendicitis therapy

et al. 2021

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Background This study aimed to investigate the diagnostic and therapeutic value of a digital single-operator cholangioscope (SOC) system for endoscopic management of acute appendicitis. Methods 14 patients with acute uncomplicated simple or supportive appendicitis were evaluated between November 2018 and September 2020. The diagnosis of acute appendicitis was confirmed by direct colonoscopy imaging and cholangioscope. The success rate of digital SOC-assisted endoscopic retrograde appendicitis therapy (ERAT), the procedure time, postoperative length of hospital stay, complications, and recurrence rate were recorded. Results Technical success rate was 100 %, with high quality imaging of the appendiceal cavity achieved using SOC in all 14 patients. The mean procedure time was 37.8 (standard deviation [SD] 22) minutes. All patients experienced immediate relief from abdominal pain after the procedure. Mean postoperative hospitalization was 1.9 (SD 0.7) days. No recurrence occurred during 2–24 months of follow-up. Conclusion Digital SOC-assisted ERAT provided a feasible, safe, and effective alternative approach for diagnosis and management of acute uncomplicated appendicitis without the need for X-ray or ultrasonic guidance.

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“…Small studies have shown that it is associated with high rates of clinical efficacy (96%-100%). 15 , 16 , 17 …”

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confidence: 99%

Prophylactic appendiceal retrograde intraluminal stent placement (PARIS)

et al. 2021

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Endoscopic retrograde appendicitis techniques for the treatment of patients with acute appendicitis

Abstract: ERAT provide a new alternative therapeutic method for patients with acute appendicitis, particularly for certain patients who are unwilling to undergo an appendectomy.

Cited by 18 publications

References 16 publications

Clinical Management of Appendicitis

Clinical Management of Appendicitis

Digital single-operator cholangioscope for endoscopic retrograde appendicitis therapy

Prophylactic appendiceal retrograde intraluminal stent placement (PARIS)

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