Management of Appendiceal Mass: Controversial Issues Revisited

Meshikhes, Abdul-Wahed Nasir

doi:10.1007/s11605-007-0399-1

Cited by 57 publications

(42 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…With the advent of antibiotics designed to prevent the growth of anaerobes, early appendectomy can now be carried out without complication 19 Hence emergency appendicectomy for appendix mass is emerging as an alternative to conventional conservative treatment. It is said to be feasible, safe, and cost-effective, allowing early diagnosis and treatment of unexpected pathology.…”

Section: Approach B Immediate Appendicectomy Following Inflammatory Mmentioning

confidence: 99%

Management of appendiceal mass

Garba

Ahmed

2008

Ann Afr Med

View full text Add to dashboard Cite

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.

show abstract

Section: Approach B Immediate Appendicectomy Following Inflammatory Mmentioning

confidence: 99%

Management of appendiceal mass

Garba

Ahmed

2008

Ann Afr Med

View full text Add to dashboard Cite

show abstract

“…Previous studies reported a high success rate of 76~97% for non-surgical treatment. [2][3][4][5][6][7][8] In the present study, there were 3 cases (3.6%) of treatment failure in non-surgical management. Two of them underwent emergent surgery under septic condition due to deterioration of inflammation despite initial antibiotic treatment.…”

Section: Discussionmentioning

confidence: 41%

“…1 Conservative management using antibiotics alone and image-guided percutaneous drainage for patients with PAA has achieved high success rates of 76% to 97%, with a low incidence of complications. [2][3][4][5][6][7][8] After achieving complete resolution of the inflammatory mass with non-surgical treatment, interval appendectomy (IA) is a less hazardous and less challenging operation, compared with ES. However, IA requires extra hospitalization for surgery and can take a long time from the time of illness to the end of treatment.…”

mentioning

confidence: 99%

Therapeutic Consideration of Periappendiceal Abscess: an Evaluation of Non-surgical Treatment Followed by Minimally Invasive Interval Appendectomy

Yang

et al. 2017

J Minim Invasive Surg

View full text Add to dashboard Cite

Purpose: Periappendiceal abscess (PAA) is a severe complicated appendicitis with high morbidity. Non-surgical treatment followed by interval appendectomy (IA) is associated with lower complication rate compared with emergency surgery (ES) and minimally invasive surgery (MIS) can be done more often. The purpose of this study is to assess the incidence and factors predictive of complications of surgery for PAA and to evaluate the clinical effectiveness of IA as a treatment policy to increase MIS.Methods: Retrospectively, we reviewed 171 patients undergoing surgery for PAA between 2011 and 2016 at Ulsan University Hospital. The incidence and influence of different factors were assessed by univariate and multivariate analyses. Results:In 171 patients, 28 (16.4%) developed postoperative complications, which included; wound complications (7.6%), intra-abdominal abscess (4.1%) and ileus (2.9%). In both analyses, only ES was independently associated with postoperative complications; (Relative risk, 15.0; 95% Confidence interval, 2.4~92.5). Comparing the IA and ES groups revealed that operative time, complication rate, laparoscopic approach, postoperative hospitalization, postoperative antibiotic use and bowel resection rate were significantly different. The postoperative complication rate of patients with PAA in ES group was 28.7%, which was statistically higher than that of IA group (3.6%). Especially, MIS rate was more than 9-times greater in the IA group (98.8% vs. 10.3%, p<0.001). Although the IA group required additional hospitalization, there was no statistical difference between the two groups in total length of hospital stay. Conclusion:Morbidity was high for patients who had emergency surgery for PAA. ES was the only factor associated with postoperative morbidity. IA can reduce the postoperative complication rate and allowed MIS to be used more often as a useful treatment policy for PAA.

show abstract

“…Failure of conservative treatment may be encountered in 10-20% of the patients. [12] Sustained fever, tachycardia, peritoneal irritation signs, and increased leukocyte count under conservative therapy can indicate the surgery. It is also argued that some ileocecal pathologies other than appendicitis, like cecal malignancy and ileocecal tuberculosis, may be undiagnosed in patients treated with conservative management.…”

Section: Discussionmentioning

confidence: 99%

Immediate appendectomy for appendiceal mass

Kaya¹,

Sana²,

Eris³

et al. 2012

Ulus Travma Acil Cerrahi Derg

View full text Add to dashboard Cite

AMAÇBu retrospektif çalışmanın amacı, apendiküler kitle tespit edilen hastalarda erken apendektominin güvenirliğini ve etkinliğini araştırmaktır. GEREÇ VE YÖNTEMVakıf Gureba Eğitim ve Araştırma Hastanesi Genel Cerrahi Kliniği'ne Ocak 2004 ile Nisan 2010 tarihleri arasın-da başvuran 47 hasta apendiküler kitle nedeni ile 24 saat içerisinde ameliyat edildi. Apendiküler kitle tanısı fiziksel inceleme, karın ultrasonografisi, bilgisayarlı tomografi ya da ameliyat sırasında konuldu. Yaş ve cinsiyet, semptomların süresi, başvuruda fiziksel inceleme bulguları, ameliyat bulguları, intraoperatif ve postoperatif komplikasyonlar ile hastanede yatış süresi her hasta için analiz edildi. BULGULARÇalışmaya 25 erkek (%53,2) ve 22 kadın (%46,8) hasta alındı. Ortalama yaş 37,23±15,60 (dağılım 14-75 yaş) idi. Semptomların başlaması ile ameliyat arasında geçen ortalama zaman 4,06±2,50 gündü (dağılım 1-15 gün). Apendektomi 38 hastada (%80,9) uygulandı. Yirmi dokuz hasta (%61,8) cerrahi sonrası herhangi bir komplikasyon olmaksızın taburcu edildi. Yara yeri enfeksiyonu 13 hastada (%27,7) saptandı. SONUÇErken apendektomi, apandiküler kitlelerde konservatif tedaviye alternatif güvenli ve etkili bir yöntemdir.Anahtar Sözcükler: Apandisit; apendiküler kitle; erken apendektomi.

show abstract

Management of Appendiceal Mass: Controversial Issues Revisited

Cited by 57 publications

References 37 publications

Management of appendiceal mass

Management of appendiceal mass

Therapeutic Consideration of Periappendiceal Abscess: an Evaluation of Non-surgical Treatment Followed by Minimally Invasive Interval Appendectomy

Immediate appendectomy for appendiceal mass

Contact Info

Product

Resources

About