Endoscopic retrograde appendicitis therapy for management of acute appendicitis

Ding, Wen-Juan; Du, Zhiqiang; Zhou, Xiang-Rong

doi:10.1007/s00464-021-08533-8

Cited by 20 publications

(20 citation statements)

References 12 publications

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“…ERAT was found to have a higher clinical success rate of 100 % in comparison to 80.9 % in the antibiotics-only cohort. ERAT also led to immediate relief of abdominal pain faster than antibiotic therapy alone, laparoscopic appendectomy (LA), or open appendectomy (OA) [10,16,20]. In two studies, length of hospital stay postoperatively was shorter in the ERAT cohort as compar- ▶ Fig.…”

Section: Discussionmentioning

confidence: 99%

“…[10,16,20] In two studies, the length of hospital stay postoperatively was shorter in the ERAT cohort as compared to antibiotic therapy alone and laparoscopic/open appendectomy. [10,16] 8…”

Section: Discussionmentioning

confidence: 99%

“…[17] The third case of perforation was thought to be caused by a guidewire injury and was managed conservatively with antibiotics. [16] The recurrence rate of appendicitis following ERAT was low with an overall rate of 6.01%. The appendix is also now thought to play a role in immune function and to possibly maintain the colonic flora favoring the potential benefit of avoiding an appendectomy.…”

Section: Accepted Manuscriptmentioning

confidence: 91%

“…Technical success was defined as successful intubation of the appendix and successful drainage of the appendiceal cavity with or without placement of a stent [10,11,[16][17][18][19]. Clinical success was defined as improvement in symptoms such as abdominal pain, nausea, and fever [10,11,[17][18][19][20].…”

Section: Definitionsmentioning

confidence: 99%

“…ed to antibiotic therapy alone and laparoscopic/open appendectomy [10,16]. ERAT appears to be safe and carries a low rate of AEs.…”

Section: E1017mentioning

confidence: 99%

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Endoscopic retrograde appendicitis therapy for acute appendicitis: a systematic review and meta-analysis

et al. 2022

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Background and study aim: Endoscopic Retrograde Appendicitis Therapy (ERAT) is an endoscopic procedure for management of patients with acute appendicitis (AA). In addition to being minimally invasive, it has added advantage of preservation of appendix and simultaneous inspection of colon. We performed a systematic review and meta-analysis on ERAT in patients with AA. Patients and methods: We conducted a comprehensive search of multiple electronic databases (from inception through Jan 2022) to identify the studies reporting ERAT in AA. The primary outcome was to evaluate the overall clinical and technical success of ERAT. The secondary outcome was to study the total and individual adverse events. The meta-analysis was performed using Der Simonian and Laird random effect model. Results 7 studies reporting on 298 patients were included. Majority of the patient population were males (55.3%), with mean age of 31±12.39 years. The pooled technical success rate was 99.36% (95% CI 97.61-100, I2=0) and the pooled clinical success rate was 99.29% (95% CI 97.48-100, I2=0). The pooled adverse event rate was 0.19 % (95% CI 0-1.55, I2=0). The most common adverse event was perforation with 0.19 % (95% CI 0-1.55, I2=0). Recurrence rate was 6.01 % (95% CI 2.9-9.93, I2=20.10). Average length of procedure was 41.1±7.16 min. Low heterogeneity was noted in in our meta-analysis. Conclusion: ERAT is a safe procedure with high clinical and technical success in patients with acute appendicitis. Further randomized controlled trials should be performed to assess utility of ERAT in acute appendicitis as compared to laparoscopic appendectomy.

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Section: Discussionmentioning

confidence: 99%

“…[10,16,20] In two studies, the length of hospital stay postoperatively was shorter in the ERAT cohort as compared to antibiotic therapy alone and laparoscopic/open appendectomy. [10,16] 8…”

Section: Discussionmentioning

confidence: 99%

Section: Accepted Manuscriptmentioning

confidence: 91%

Section: Definitionsmentioning

confidence: 99%

“…ed to antibiotic therapy alone and laparoscopic/open appendectomy [10,16]. ERAT appears to be safe and carries a low rate of AEs.…”

Section: E1017mentioning

confidence: 99%

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Endoscopic retrograde appendicitis therapy for acute appendicitis: a systematic review and meta-analysis

et al. 2022

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Contrast‐Enhanced Ultrasound‐Guided Endoscopic Retrograde Appendicitis Treatment—A Pilot Study on the Diagnostic and Therapeutic Efficacy in Uncomplicated Appendicitis

Chen,

Li,

Chen

et al. 2024

J of Ultrasound Medicine

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ObjectiveTo determine the diagnostic and therapeutic value of contrast‐enhanced ultrasound‐guided endoscopic retrograde appendicitis treatment (ERAT) in patients with uncomplicated appendicitis.MethodsA retrospective analysis was performed on clinical and ultrasound data collected from 105 pediatric patients with uncomplicated appendicitis between January 2020 and December 2023. The ultrasound findings before and after treatment, as well as postoperative follow‐up and recurrence rates, were summarized and analyzed.ResultsSuccessful intubation was achieved in 96 patients (91.4%). The conventional ultrasound appendix visualization rate was 39.6% (38/105), while the appendix visualization rate after contrast‐enhanced ultrasound‐guidance was 75% (72/105). Contrast‐enhanced ultrasound revealed various appendiceal morphologic changes in 89 patients, such as twisting, tortuosity, stiffness, rough inner wall, dilated diameter, and narrowing of the lumen. Additionally, local filling defects, which indicated the presence of fecal stones or debris deposition, were noted in 68 patients. No leakage of the contrast agent occurred. Post‐treatment evaluation showed improvement in appendiceal diameter, lumen, and filling defects (P < .01). The follow‐up rate was 82 of 89 patients (92.1%), all of whom recovered well without a recurrence. The recurrence rate was 7.9% (7/89). Among the patients with recurrences, five patients resolved after medical treatment and two patients recovered after surgical treatment.ConclusionContrast‐enhanced ultrasound‐guided ERAT for uncomplicated appendicitis is safe and effective. Specifically, the appendix is increased, which facilitates an evaluation of therapeutic effectiveness. ERAT serves as a valuable supplementary modality to determine the need for surgical treatment of acute appendicitis, which is of significant clinical value.

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Application value of high-frequency ultrasonography in endoscopic retrograde appendicitis therapy for pediatric acute appendicitis

Guo¹,

Yang

Li³

et al. 2023

Surg Endosc

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Endoscopic retrograde appendicitis therapy for management of acute appendicitis

Cited by 20 publications

References 12 publications

Endoscopic retrograde appendicitis therapy for acute appendicitis: a systematic review and meta-analysis

Endoscopic retrograde appendicitis therapy for acute appendicitis: a systematic review and meta-analysis

Contrast‐Enhanced Ultrasound‐Guided Endoscopic Retrograde Appendicitis Treatment—A Pilot Study on the Diagnostic and Therapeutic Efficacy in Uncomplicated Appendicitis

Application value of high-frequency ultrasonography in endoscopic retrograde appendicitis therapy for pediatric acute appendicitis

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