COMMENTARY

Appendicitis Without Appendectomy?

Albert B. Lowenfels, MD

September 18, 2014

Long-term Outcomes of Patients With Nonsurgically Managed Uncomplicated Appendicitis

McCutcheon BA, Chang DC, Marcus LP, et al
J Am Coll Surg. 2014;218:905-913

Study Summary

The aim of this observational, nonrandomized study using statewide data from California was to compare results after suspected onset of appendicitis in surgically managed (n = 231,678) vs nonsurgically managed (n= 3236) patients. The 30-day mortality rates were 1.5% in the nonsurgical group vs 0.1% in the surgical group (P < .001), and in-hospital total charges were higher in the nonsurgical group (P < .001). During the short-term follow-up period, about 6% of the nonsurgical patients required appendectomy; over a period of several years, about 4% of patients had a recurrent attack of appendicitis.

Viewpoint

The small group of patients managed nonsurgically (about 1.5% of the total group) differed from the larger group of surgical patients in that they were older and more likely to suffer from other diseases. Nevertheless, it is impressive that in this unselected group of conservatively managed patients, only 10% of the overall group eventually required surgery. A randomized trial currently under way in Finland will provide some answers^[1]; in the meantime, appendectomy will still be the favored approach for the management of this common disease.

Abstract

References

Cite this: Albert B. Lowenfels. Appendicitis Without Appendectomy? - Medscape - Sep 18, 2014.

Comments

Commenting is limited to medical professionals. To comment please Log-in.

Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.