To Determine the Effectiveness of Conservative Treatment Versus Appendectomy in the Management of Acute Uncomplicated Appendicitis.

Authors

  • Mian Anwar Zeb Swat Medical College, Saidu Sharif Swat
  • Muhammad Usman Swat Medical College, Saidu Sharif Swat
  • Farooq Khan Saidu Medical College, Swat
  • Siyab Ahmad Swat Medical College, Saidu Sharif Swat
  • Liaqat Ali Swat Medical College, Saidu Sharif Swat
  • Adnan Badar Saidu Medical College, Saidu Sharif Swat

DOI:

https://doi.org/10.52206/jsmc.2024.14.1.797

Abstract

Background: The vermiform appendix is considered to be a vestigial organ by the most. Its importance in surgery results only from its tendency for inflammation that results in a clinical syndrome known as acute appendicitis. It is the most common indication for emergency abdominal surgery in patients with acute abdomen with a crude annual incidence of 26 per 10,000 populations.
Objectives: To determine the effectiveness of Conservative Treatment Versus appendectomy in the management of Acute
Uncomplicated Appendicitis.
Material and Methods: This randomized control trial was conducted in Department of General Surgery Saidu Group of Teaching Hospital Saidu sharif, from 1st January 2022 to 31st December 2022. A total of 96 cases were enrolled, that were divided into two groups. Informed written consent was taken from each patient. Patients in Group A were subjected to non-operative management with antibiotics while patients in Group B were subjected to appendectomy. Patients in both groups were evaluated for various parameters such as age, gender, pre- and post-operative duration of pain (group B), Alvarado score. Post stratification chi-square test was applied keeping P Value < 0.05 as significant.
Results: Mean and SD for Age, Duration of Stay, Pre & Post Treatment Abdominal Score and Pre and Post Treatment Alvarado Score in Group A was recorded as 35±10.60, 3.0±0.24, 7.0±0.49, 3.0±0.20, 9.0±0.41 and 3.0±1.62 respectively. In the same manner, Mean and SD for Group B was 35±12.53, 5.0±0.41, 7.0±0.35, 3.0±0.35, 3.0±0.20, 9.0±0.41, and 2.5±1.5, respectively. Success rate in Group A was 26 (52%) whereas in Group B it was 36 (72%) patients.
Conclusion: Conservative treatment can be applied safely in the majority of cases of the first attack of uncomplicated acute appendicitis, therefore, avoiding appendectomy and its associated morbidity and mortality.
Keywords: Acute appendicitis, Alvarado Score, Antibiotic treatment, Acute uncomplicated appendicitis, Success rate.

References

Talan DA, Saltzman DJ, DeUgarte DA, Moran GJ. Methods of conservative antibiotic treatment of acute uncomplicated appendicitis: A systematic review. The Journal of Trauma and Acute Care Surgery. 2019:10(4):722-31.

Msolli MA, Beltaief K, Bouida W, et al. Value of early change of serum C reactive protein combined to modified Alvarado score in the diagnosis of acute appendicitis. BMC Emerg Med 2018;135(15):538-546.

Kadam MM. Clinico Sonological Evaluation of Right Iliac Fossa Mass (Doctoral dissertation, Rajiv Gandhi University of Health Sciences 2016;10(1):38-56.

Carboni F, Valle M, Vaira M, Sammartino P, Federici O, Robella M, et al. Complications and mortality rate of cytoreductive surgery with hyperthermic intraperitoneal chemotherapy: Italian peritoneal surface malignancies oncoteam results analysis. Cancers. 2022;14(23):5824-5836.

Thomson JE, Kruger D, Jann-Kruger C, Kiss A, Omoshoro-Jones JA, Luvhengo T, et al.Laparoscopic versus open surgery for complicated appendicitis: a randomized controlled trial to prove safety. Surgical endoscopy. 2019:29(6):2027-32.

Hemant N, Shabi A, Keshwani NK, Awasthi DN. Combined use of modified Alvarado score and USG in decreasing negative appendicectomy rate. Indian J Surg 2019;72(5):42-48.

Boudewijn R, Toorenvliet, Fraukje W, Rutger FR, Jos WS Merkus, Paul J, et al. Routine ultrasound and limited computed tomography for the diagnosis of acute appendicitis. World J Surg 2019;34(5): 2278-85.

Gamal K. Acute appendicitis:is removal of a normal appendix still existing and can we reduce its rate? Saudi J Gastroenterol. 2019;5(3):167-70.

Fabio P, Antonio P, Anna R, Francesco C, Renata, Paolo, et al. Accuracy of ultrasonography in the diagnosis of acute appendicitis in adult patients: review of the literature. Cr Ultrasound J 2018;5(56): 123-129.

Tariq WK, Abdul S, Champa S. Negative appendectomy Rate: Can It Be Reduced?. J LiaquatUni Med Health Sci2009 JAN-APR; 2018; 8(01):19-22.

Sheikh M S, Misbha A,Farooq A. Reshi. Total leucocyte count,c reactive protein and neutrophil count diagnostic aid in acute appendicitis. Saudi J Gastroenterol. 2019;15(2):117-20.

Minneci PC, Sulkowski JP, Nacion KM, Mahida JB, Cooper JN, Moss RL, et al. Antibiotics alone as an alternative therapy for uncomplicated pediatric appendicitis. J Am C 9. Surg. 2019;219(4):27-35.

Spontaneous resolution and predominance of prehospital perforations imply that a correct diagnosis is more important than an early diagnosis. World J Surg. 2017;31(26):86-92

Ansaloni L, Catena F, Coccolini F, Ercolani G, Gazzotti F, Pasqualini E, et al. Surgery versus conservative antibiotic treatment in acute appendicitis: a systematic review and metaanalysis of randomized controlled trials. Dig Surg. 2019; 28(3):210-21.

Wilms IM, de Hoog DE, de Visser DC, Janzing HM. Appendectomy versus antibiotic Treatment for acute appendicitis. Cochrane Database Syst Rev. 2017:23(11):83-59.

Emad H, Abdelaziz G, Aly S, Ossama Z, Abdulhameed A. Conservative treatment versus appendectomy for acute uncomplicated appendicitis. J Surg. Special Issue: Gastrointestinal Surgery: Recent Trends. 2019; 4(2):27-30.

Frazee RC,Abernathy SW, Davis M,Hendricks JC,Isbell TV et al. Outpatient laparoscopic appendectomy should be the standard of care for uncomplicated appendicitis. J Trauma Acute Care Surg. 2018;76(1):79-82.

Additional Files

Published

08-03-2024

How to Cite

1.
Mian Anwar Zeb, Muhammad Usman, Farooq Khan, Siyab Ahmad, Liaqat Ali, Adnan Badar. To Determine the Effectiveness of Conservative Treatment Versus Appendectomy in the Management of Acute Uncomplicated Appendicitis. J Saidu Med Coll [Internet]. 2024 Mar. 8 [cited 2025 Jan. 25];14(1):19-23. Available from: https://jsmc.pk/index.php/jsmc/article/view/797

Most read articles by the same author(s)

1 2 > >>