{"title":"急性阑尾炎的非手术治疗可行吗？叙述性综述","authors":"Hani Bendib","doi":"10.1016/j.afjem.2024.03.006","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><p>Acute appendicitis (AA) represents the most frequent surgical emergency. Perforation was long considered the ultimate outcome of AA, prompting appendectomy; which remains the standard treatment. New data have clarified the role of the appendix, justifying conservative treatment. This narrative review aims to summarize the evidence regarding the non-operative treatment (NOT) of AA in adults.</p></div><div><h3>Methods</h3><p>The literature search was performed via the PubMed Medline database. Our criteria-based selection resulted in a total of 48 articles for review.</p></div><div><h3>Results</h3><p>Recent trials and meta-analyses have assessed NOT, which support primary antibiotic treatment of uncomplicated AA. Although it has a significant recurrence and failure rate, NOT does not appear to increase the risk of appendicular perforation. Moreover, NOT compared with appendectomy, seems to be associated with less morbidity, lower cost of care and preserved quality of life.</p></div><div><h3>Conclusion</h3><p>First-line NOT seems to be a reasonable approach for the treatment of uncomplicated CT-confirmed AA. Careful patient screening would definitely enhance the success rate.</p></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"14 2","pages":"Pages 84-90"},"PeriodicalIF":1.4000,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2211419X24000107/pdfft?md5=5f88724ff5585c25f76646bc601c0ae1&pid=1-s2.0-S2211419X24000107-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Is non-operative treatment of acute appendicitis possible: A narrative review\",\"authors\":\"Hani Bendib\",\"doi\":\"10.1016/j.afjem.2024.03.006\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction</h3><p>Acute appendicitis (AA) represents the most frequent surgical emergency. Perforation was long considered the ultimate outcome of AA, prompting appendectomy; which remains the standard treatment. New data have clarified the role of the appendix, justifying conservative treatment. This narrative review aims to summarize the evidence regarding the non-operative treatment (NOT) of AA in adults.</p></div><div><h3>Methods</h3><p>The literature search was performed via the PubMed Medline database. Our criteria-based selection resulted in a total of 48 articles for review.</p></div><div><h3>Results</h3><p>Recent trials and meta-analyses have assessed NOT, which support primary antibiotic treatment of uncomplicated AA. Although it has a significant recurrence and failure rate, NOT does not appear to increase the risk of appendicular perforation. Moreover, NOT compared with appendectomy, seems to be associated with less morbidity, lower cost of care and preserved quality of life.</p></div><div><h3>Conclusion</h3><p>First-line NOT seems to be a reasonable approach for the treatment of uncomplicated CT-confirmed AA. Careful patient screening would definitely enhance the success rate.</p></div>\",\"PeriodicalId\":48515,\"journal\":{\"name\":\"African Journal of Emergency Medicine\",\"volume\":\"14 2\",\"pages\":\"Pages 84-90\"},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2024-04-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S2211419X24000107/pdfft?md5=5f88724ff5585c25f76646bc601c0ae1&pid=1-s2.0-S2211419X24000107-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"African Journal of Emergency Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2211419X24000107\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"EMERGENCY MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"African Journal of Emergency Medicine","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2211419X24000107","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"EMERGENCY MEDICINE","Score":null,"Total":0}
引用次数: 0
摘要
导言急性阑尾炎（AA）是最常见的外科急症。长期以来，穿孔被认为是急性阑尾炎的最终结局，因此必须进行阑尾切除术，这也是目前的标准治疗方法。新的数据阐明了阑尾的作用，为保守治疗提供了依据。本综述旨在总结有关成人 AA 非手术治疗（NOT）的证据。结果近期的试验和荟萃分析对非手术治疗进行了评估，结果支持对无并发症的 AA 进行初级抗生素治疗。尽管NOT的复发率和失败率较高，但似乎不会增加阑尾穿孔的风险。此外，与阑尾切除术相比，NOT 似乎发病率更低、护理成本更低，并能保证患者的生活质量。对患者进行仔细筛查无疑会提高成功率。
Is non-operative treatment of acute appendicitis possible: A narrative review
Introduction
Acute appendicitis (AA) represents the most frequent surgical emergency. Perforation was long considered the ultimate outcome of AA, prompting appendectomy; which remains the standard treatment. New data have clarified the role of the appendix, justifying conservative treatment. This narrative review aims to summarize the evidence regarding the non-operative treatment (NOT) of AA in adults.
Methods
The literature search was performed via the PubMed Medline database. Our criteria-based selection resulted in a total of 48 articles for review.
Results
Recent trials and meta-analyses have assessed NOT, which support primary antibiotic treatment of uncomplicated AA. Although it has a significant recurrence and failure rate, NOT does not appear to increase the risk of appendicular perforation. Moreover, NOT compared with appendectomy, seems to be associated with less morbidity, lower cost of care and preserved quality of life.
Conclusion
First-line NOT seems to be a reasonable approach for the treatment of uncomplicated CT-confirmed AA. Careful patient screening would definitely enhance the success rate.
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