Appendicectomy for Uncomplicated Simple Appendicitis: Is It Always Required?. (15th March 2021)

• Record Type: Journal Article
• Authors: Falih Noori Alsubsiee, Ibrahim; Falih Noori Alsubsiee, Ahmed
• Other Names: Manousos Georgios Pramateftakis Academic Editor.
• Is Part Of: Surgery research and practice. Volume 2021(2021)
• Publication Date: 2021-03-15
• Subjects: Surgery -- Periodicals; 617.005
• DOI: 10.1155/2021/8848162
• Languages: English
• ISSNs: 2356-7759

Abstract

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.