Is There Still a Place for Interval Appendectomy?

Verwaal, Vic J.; Wobbes, Theo; Goris, J.A.

doi:10.1159/000172196

Cited by 17 publications

(18 citation statements)

References 2 publications

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“…It is first to prevent recurrence of acute appendicitis and second to avoid misdiagnosing an alternative pathology such as malignancy. 12,14,16 An article in favor of initial conservative approach published in 1993 by Nitecki et al 2 reported a mean incidence of recurrent acute appendicitis in a metaanalysis of 329 patients managed conservatively as 13.7% (range 0%-20%).…”

Section: Discussionmentioning

confidence: 99%

Management of appendiceal mass

Garba

Ahmed

2008

Ann Afr Med

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Background:The management of appendiceal mass is surrounded with controversy. Traditional management has been conservative, with interval appendicectomy performed weeks after the mass had resolved. This remains the most common approach at many centers in the world. Recently, an increasing number of studies have challenged this approach. This article reviews some of the controversial issues in the management of appendix mass, assesses current practice and suggests an appropriate approach for the management of appendix mass. Methods: A Medline, Pubmed and Cochrane database search were used to find such key words and combinations of: appendix, appendiceal, appendicular, interval, appendectomy, appendicectomy, mass, abscess, phlegmon, and appendicitis. Results were saved and managed by Reference manager 11. All articles were cross-referenced by the authors. Results: A conservative management is still a highly acceptable approach for appendix mass. This should be followed with interval appendicectomy especially in patients with persistent right iliac fossa pain. Conclusion:We recommend initially conservative approach to the management of appendiceal mass especially in our environment. Keywords: Appendiceal mass, appendix abscess, appendix phlegmon, appendicitis, interval appendicectomyRésumé Contexte: La prise en charge du plastron appendiculaire est entoure de controverses. Le traitement usuel a toujours été conservateur avec l'appendicectomie réalisée plusieurs semaines après la fonte de la masse. C'est l'attitude la plus commune dans la plupart des centres à travers le monde. Récemment, un nombre croissant d'études ont conteste cette approche. Cet article passe en revue certaines controverses dans la prise en charge du plastron appendiculaire, présente les pratiques actuelles, et suggère une approche appropriée de la prise en charge du plastron appendiculaire. Méthode: Une recherche dans les bases documentaires Medline, Pubmed et Cochrane ont été faites par la recherche et la combinaison des mots clés que sont: appendice, appendiculaire, intervalle, appendicectomie, masse, abcès, phlegmon et appendicite. Les résultats ont été sauvegardes et traites a l'aide de Référence Manager 11. Tous les articles ont été recoupes par les auteurs. Résultats: Un traitement conservateur est encore une approche très acceptable pour le plastron appendiculaire. Cela devrait être suivi à distance par une appendicectomie particulièrement chez les patients ayant une douleur persistante de la fosse iliaque droite. Conclusion: Nous recommandons initialement une approche conservatrice pour la prise en charge du plastron appendiculaire particulièrement dans notre contexte.

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Section: Discussionmentioning

confidence: 99%

Management of appendiceal mass

Garba

Ahmed

2008

Ann Afr Med

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“…Earlier studies have recommended interval appendicectomy after 6-12 weeks because of the risks of recurrent appendicitis (15,18) and of missing an underlying malignancy (4,9,15,19,23). More recent studies question interval appendicectomy and recommend selective interval appendicectomy in patients over 40 years of age, so as not to miss a malignancy (6,8,9,13,15,23), or even nd it unnecessary (5).…”

Section: Introductionmentioning

confidence: 99%

“…More recent studies question interval appendicectomy and recommend selective interval appendicectomy in patients over 40 years of age, so as not to miss a malignancy (6,8,9,13,15,23), or even nd it unnecessary (5).…”

Section: Introductionmentioning

confidence: 99%

Appendiceal abscesses: primary percutaneous drainage and selective interval appendicectomy

et al. 2002

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Appendiceal abscesses can be effectively drained percutaneously using ultrasound-guided drainage under local anaesthesia, without complications. Recurrent appendicitis is common, and malignancy is a substantial risk in elderly patients. Modern laparoscopic appendicectomy and early postoperative discharge makes interval appendicectomy a valid treatment option after primary non-surgical management of appendiceal abscesses.

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“…These results are comparable to other study. [4][5][6][7][8][9] In this study appendicular phlegmon was most common (57.14%) finding during surgery followed by gangrene.…”

Section: Discussionmentioning

confidence: 94%

Appendicular lump: comparative study of immediate surgical versus conservative management

Agarwal¹,

Agrawal²

2017

Int Surg J

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Background: At present acute appendicitis is leading cause of acute surgical abdomen. Treatment of choice for non-complicated appendicitis is appendicectomy. Delayed presentation of appendicitis cause lump formation in 2-6% case. Traditional treatment of appendicular lump is conservative treatment followed by interval appendicectomy. Our study was done to make a better management plan for lump patients.Methods: In this retrospective study 52 patients having appendicular lump randomly divided in two group, Group 1 conservative treatment followed by interval appendicectomy after 6-8 weeks and group 2 immediate surgery. Highest incidence of appendicular lump was found in age group of 21-30 year. Average hospital stay in group 1 was 12 days as compare to 4 day in group 2.Results: Immediate surgery in our study suggest better management plan for appendicular lump in term of less hospital stay, less economic burden, no need of readmission in hospital and no major complication.Conclusions: Early exploration for appendicular lump is preferred option rather than conservative treatment followed by interval appendicectomy.

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Is There Still a Place for Interval Appendectomy?

Cited by 17 publications

References 2 publications

Management of appendiceal mass

Management of appendiceal mass

Appendiceal abscesses: primary percutaneous drainage and selective interval appendicectomy

Appendicular lump: comparative study of immediate surgical versus conservative management

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