Appendicectomy for Uncomplicated Simple Appendicitis: Is It Always Required?

Surgery Research and Practice Pub Date : 2021-03-15 eCollection Date: 2021-01-01 DOI:10.1155/2021/8848162
Ibrahim Falih Noori Alsubsiee, Ahmed Falih Noori Alsubsiee
{"title":"Appendicectomy for Uncomplicated Simple Appendicitis: Is It Always Required?","authors":"Ibrahim Falih Noori Alsubsiee, Ahmed Falih Noori Alsubsiee","doi":"10.1155/2021/8848162","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Although appendicectomy is still the classical and standard treatment for acute appendicitis, initial conservative antibiotic only treatment for simple uncomplicated cases has been proposed and tried as a feasible and effective approach. The objective of this study was to evaluate the efficacy and outcomes of antibiotics treatment for acute simple uncomplicated appendicitis.</p><p><strong>Methods: </strong>This is a prospective controlled nonrandomized study in which a total of 156 patients whose ages range from 16 to 54 years presenting with clinical diagnosis of acute uncomplicated appendicitis were assigned for conservative antibiotics treatment, which consists of ceftriaxone I gram twice daily and metronidazole infusions, 500 mg in 100 ml, 3 times daily for 48 to 72 hours to be converted on oral antibiotics after clinical improvement for 5 to 7 days. Patients who failed to initial conservative treatment and those who had recurring symptoms of appendicitis were presented for appendectomy.</p><p><strong>Results: </strong>Antibiotic treatment was successful and feasible in 138 (88.5%) patients. Progression of the signs and symptoms despite full medical treatment was observed in 11 (7%) patients during the same admission. Further 7 (4.5%) patients showed recurrence of the symptoms during follow-up period of 6-12 months after successful initial conservative treatment and also proceeded for appendicectomy.</p><p><strong>Conclusion: </strong>Nonoperative antibiotic treatment of acute simple appendicitis is safe, feasible, and effective for properly selected cases, thus avoiding unnecessary surgery with its possible complications.</p>","PeriodicalId":30584,"journal":{"name":"Surgery Research and Practice","volume":"2021 ","pages":"8848162"},"PeriodicalIF":0.0000,"publicationDate":"2021-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7984904/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Surgery Research and Practice","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1155/2021/8848162","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2021/1/1 0:00:00","PubModel":"eCollection","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

Abstract

Background: Although appendicectomy is still the classical and standard treatment for acute appendicitis, initial conservative antibiotic only treatment for simple uncomplicated cases has been proposed and tried as a feasible and effective approach. The objective of this study was to evaluate the efficacy and outcomes of antibiotics treatment for acute simple uncomplicated appendicitis.

Methods: This is a prospective controlled nonrandomized study in which a total of 156 patients whose ages range from 16 to 54 years presenting with clinical diagnosis of acute uncomplicated appendicitis were assigned for conservative antibiotics treatment, which consists of ceftriaxone I gram twice daily and metronidazole infusions, 500 mg in 100 ml, 3 times daily for 48 to 72 hours to be converted on oral antibiotics after clinical improvement for 5 to 7 days. Patients who failed to initial conservative treatment and those who had recurring symptoms of appendicitis were presented for appendectomy.

Results: Antibiotic treatment was successful and feasible in 138 (88.5%) patients. Progression of the signs and symptoms despite full medical treatment was observed in 11 (7%) patients during the same admission. Further 7 (4.5%) patients showed recurrence of the symptoms during follow-up period of 6-12 months after successful initial conservative treatment and also proceeded for appendicectomy.

Conclusion: Nonoperative antibiotic treatment of acute simple appendicitis is safe, feasible, and effective for properly selected cases, thus avoiding unnecessary surgery with its possible complications.

针对不复杂的单纯性阑尾炎的阑尾切除术:是否一定需要?
背景:尽管阑尾切除术仍是急性阑尾炎的经典和标准治疗方法,但对于简单无并发症的病例,仅使用抗生素进行初步保守治疗是一种可行且有效的方法。本研究旨在评估抗生素治疗急性单纯性无并发症阑尾炎的疗效和结果:这是一项前瞻性非随机对照研究,共选取了 156 名临床诊断为急性无并发症阑尾炎的患者(年龄在 16 至 54 岁之间)进行抗生素保守治疗,包括头孢曲松 I 克,每日 2 次,甲硝唑输液 500 毫克,100 毫升,每日 3 次,持续 48 至 72 小时,待临床症状改善后转为口服抗生素治疗 5 至 7 天。初步保守治疗失败和阑尾炎症状反复发作的患者则接受阑尾切除术:结果:138 例(88.5%)患者的抗生素治疗是成功可行的。有 11 名(7%)患者在入院时接受了全面的药物治疗,但症状和体征仍在恶化。另有 7 名患者(4.5%)在最初的保守治疗成功后 6-12 个月的随访期间症状复发,并进行了阑尾切除术:结论:急性单纯性阑尾炎的非手术抗生素治疗对于经过适当选择的病例是安全、可行和有效的,从而避免了不必要的手术及其可能的并发症。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
自引率
0.00%
发文量
7
期刊介绍: Surgery Research and Practice is a peer-reviewed, Open Access journal that provides a forum for surgeons and the surgical research community. The journal publishes original research articles, review articles, and clinical studies focusing on clinical and laboratory research relevant to surgical practice and teaching, with an emphasis on findings directly affecting surgical management.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信