The Efficacy of Conservative Management in Uncomplicated Acute Appendicitis - A Single-Center Retrospective Study

Abstract

BackgroundAcute appendicitis remains the most common cause of lower abdominal pain leading to emergency visits. Even though the standard treatment of acute appendicitis remains appendectomy, in recent times, multiple randomized control trials and meta-analyses have deduced conservative treatment as a successful alternative treatment. During the coronavirus disease (COVID) pandemic, with a shortage of staff and resources, treatment with conservative management of uncomplicated acute appendicitis became very beneficial under certain circumstances and conditions. This study aimed to assess whether it is effective to manage patients with uncomplicated acute appendicitis with antibiotic therapy. MethodologyThis was a single hospital based retrospective, cross-sectional study from Jan 2015 to May 2020. Patients with clinical and radiological features of uncomplicated acute appendicitis with Alvarado's score >6 were included in the study. Patients were kept on antibiotics, intravenous fluids, and analgesia as part of a conservative regime. Those who failed to respond to conservative therapy were managed surgically. The follow-up period was six months. ResultsOne hundred eighty-two cases of uncomplicated acute appendicitis were included and managed conservatively, of which 52.2% were males while 47.8% were females. The median age of the patients was 26 years. Conservative treatment was successful in 26.2% of the patients, with a recurrence of 5.5% in the sixmonth follow-up period. The mean number of days of hospital stay was three days in patients treated with conservative or surgical treatment. ConclusionConservative management is gaining popularity, and many centers are inclined towards non-operative management; however, appendectomy remains the gold standard treatment for appendicitis.

The Efficacy of Antibiotics in Acute Appendicitis Treatment : A Comprehensive Systematic Review

“…Table 1 compiles the literature that was analyzed for this analysis in order to make it easier to view. 6 showed conservative management is no doubt gaining ground, and a lot of centers are inclined towards non-operative management; therefore, further randomized controlled trials and meta-analyses should be carried out on the matter for a more conclusive verdict.…”