Amram Kupietzky, Yehonatan Bar-Moshe, Nofar Lavie, Moriya Drayer Lichtman, Roi Dover, Eyal Yonathan Juster, Ata Maden, Haggi Mazeh, Ido Mizrahi
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The primary outcome was defined as a recurrence of AA.</p><p><strong>Results: </strong>During the study period, 797 patients were treated with NOM for AA. Their mean age was 25.4 years ± 14.4 years, and 45.4% were females. Only 68 patients (8.5%) had an appendicolith identified on imaging. Patients with an appendicolith had a larger appendix diameter (10.2 mm ± 4 mm <i>vs</i> 8.5 mm ± 2.1 mm, <i>P</i> = 0.001). There was no difference in the recurrence rate of patients with and without an appendicolith (26.5% <i>vs</i> 19.1%, <i>P</i> = 0.14), however patients with an appendicolith presented with a shorter time to recurrence of appendicitis (3.9 months ± 10.4 months <i>vs</i> 5.9 months ± 8.1 months, <i>P</i> = 0.04). In a sub analysis, the number of appendicoliths, its size, and its location, did not influence the recurrence rate.</p><p><strong>Conclusion: </strong>This study demonstrates that patients with appendicoliths have a shorter time to recurrence after NOM of AA, but do not experience higher overall recurrence rates.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 23","pages":"106532"},"PeriodicalIF":1.0000,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188775/pdf/","citationCount":"0","resultStr":"{\"title\":\"Leaving no stone unturned: Impact of appendicolith and characteristics on long-term recurrence after non-operative appendicitis.\",\"authors\":\"Amram Kupietzky, Yehonatan Bar-Moshe, Nofar Lavie, Moriya Drayer Lichtman, Roi Dover, Eyal Yonathan Juster, Ata Maden, Haggi Mazeh, Ido Mizrahi\",\"doi\":\"10.12998/wjcc.v13.i23.106532\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Non-operative management (NOM) for uncomplicated acute appendicitis (AA) has been gaining popularity in recent years. One of the major concerns with NOM is the recurrence rate of AA following NOM.</p><p><strong>Aim: </strong>To investigate the impact of the presence of an appendicolith and its specific characteristics on the recurrence rate of AA following NOM.</p><p><strong>Methods: </strong>A retrospective analysis identified all patients treated with NOM for AA, at our institute between 2016 and 2024. Patients with an appendicolith on imaging were identified and their course and outcomes were compared with patients who were treated with NOM without an appendicolith. The primary outcome was defined as a recurrence of AA.</p><p><strong>Results: </strong>During the study period, 797 patients were treated with NOM for AA. Their mean age was 25.4 years ± 14.4 years, and 45.4% were females. Only 68 patients (8.5%) had an appendicolith identified on imaging. Patients with an appendicolith had a larger appendix diameter (10.2 mm ± 4 mm <i>vs</i> 8.5 mm ± 2.1 mm, <i>P</i> = 0.001). There was no difference in the recurrence rate of patients with and without an appendicolith (26.5% <i>vs</i> 19.1%, <i>P</i> = 0.14), however patients with an appendicolith presented with a shorter time to recurrence of appendicitis (3.9 months ± 10.4 months <i>vs</i> 5.9 months ± 8.1 months, <i>P</i> = 0.04). 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引用次数: 0
摘要
背景:非手术治疗非复杂性急性阑尾炎(AA)近年来越来越受欢迎。目的:探讨阑尾结肠炎的存在及其特征对非外科手术后AA复发率的影响。方法:回顾性分析我院2016 - 2024年所有接受非外科手术后AA治疗的患者。影像学检查发现阑尾结石的患者,并将其病程和结果与未发现阑尾结石的患者进行比较。主要终点被定义为AA复发。结果:在研究期间,797例AA患者接受了NOM治疗。平均年龄25.4岁±14.4岁,女性占45.4%。仅有68例(8.5%)患者在影像学上发现阑尾结石。阑尾结石患者的阑尾直径较大(10.2 mm±4 mm vs 8.5 mm±2.1 mm, P = 0.001)。两组复发率差异无统计学意义(26.5% vs 19.1%, P = 0.14),但有阑尾炎的患者复发时间较短(3.9个月±10.4个月vs 5.9个月±8.1个月,P = 0.04)。在次级分析中,阑尾结石的数量、大小和位置对复发率没有影响。结论:本研究表明,AA术后阑尾结石患者的复发时间较短,但总体复发率不高。
Leaving no stone unturned: Impact of appendicolith and characteristics on long-term recurrence after non-operative appendicitis.
Background: Non-operative management (NOM) for uncomplicated acute appendicitis (AA) has been gaining popularity in recent years. One of the major concerns with NOM is the recurrence rate of AA following NOM.
Aim: To investigate the impact of the presence of an appendicolith and its specific characteristics on the recurrence rate of AA following NOM.
Methods: A retrospective analysis identified all patients treated with NOM for AA, at our institute between 2016 and 2024. Patients with an appendicolith on imaging were identified and their course and outcomes were compared with patients who were treated with NOM without an appendicolith. The primary outcome was defined as a recurrence of AA.
Results: During the study period, 797 patients were treated with NOM for AA. Their mean age was 25.4 years ± 14.4 years, and 45.4% were females. Only 68 patients (8.5%) had an appendicolith identified on imaging. Patients with an appendicolith had a larger appendix diameter (10.2 mm ± 4 mm vs 8.5 mm ± 2.1 mm, P = 0.001). There was no difference in the recurrence rate of patients with and without an appendicolith (26.5% vs 19.1%, P = 0.14), however patients with an appendicolith presented with a shorter time to recurrence of appendicitis (3.9 months ± 10.4 months vs 5.9 months ± 8.1 months, P = 0.04). In a sub analysis, the number of appendicoliths, its size, and its location, did not influence the recurrence rate.
Conclusion: This study demonstrates that patients with appendicoliths have a shorter time to recurrence after NOM of AA, but do not experience higher overall recurrence rates.
期刊介绍:
The World Journal of Clinical Cases (WJCC) is a high-quality, peer reviewed, open-access journal. The primary task of WJCC is to rapidly publish high-quality original articles, reviews, editorials, and case reports in the field of clinical cases. In order to promote productive academic communication, the peer review process for the WJCC is transparent; to this end, all published manuscripts are accompanied by the anonymized reviewers’ comments as well as the authors’ responses. The primary aims of the WJCC are to improve diagnostic, therapeutic and preventive modalities and the skills of clinicians and to guide clinical practice in clinical cases.