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©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Aug 28, 2017; 23(32): 5849-5859
Published online Aug 28, 2017. doi: 10.3748/wjg.v23.i32.5849
Laparoscopic appendectomy for acute appendicitis: How to discourage surgeons using inadequate therapy
Tomohide Hori, Tsunehiro Yoshimura, Shigeo Hisamori, Taku Kitano, Yuichi Takamatsu, Maho Sasaki, Yusuke Kimura, Yuki Aisu, Daiki Yasukawa, Shigeru Kato, Tatsuo Ito, Toshiyuki Hata, Yoshio Kadokawa, Takafumi Machimoto
Tomohide Hori, Takafumi Machimoto, Yoshio Kadokawa, Toshiyuki Hata, Tatsuo Ito, Shigeru Kato, Daiki Yasukawa, Yuki Aisu, Yusuke Kimura, Maho Sasaki, Yuichi Takamatsu, Taku Kitano, Shigeo Hisamori, Tsunehiro Yoshimura, Department of Gastrointestinal Surgery, Tenriyorodusoudanjyo Hospital, Tenri, Nara 632-8552, Japan
Author contributions: Hori T drew all of the schemas, collected the data, and wrote this review; Machimoto T, Kadokawa Y, Hata T, Ito T, Kato S, Yasukawa D, Aisu Y, Kimura Y, Sasaki M, Takamatsu Y, Kitano T and Hisamori S provided academic opinions on the review and helped to assess important papers; Yoshimura T supervised this review.
Conflict-of-interest statement: No potential conflicts of interest.
Correspondence to: Tomohide Hori, PhD, MD, FACS, Department of Gastrointestinal Surgery, Tenriyorodusoudanjyo Hospital, 200 Mishima-cho, Tenri, Nara 632-8552, Japan. horitomo@tenriyorozu.jp
Telephone: +81-743-635611 Fax: +81-743-631530
Received: May 12, 2017
Peer-review started: May 16, 2017
First decision: June 5, 2017
Revised: July 25, 2017
Accepted: August 1, 2017
Article in press: August 2, 2017
Published online: August 28, 2017
Processing time: 107 Days and 22 Hours
Core Tip

Core tip: Acute appendicitis develops in a progressive and irreversible manner, and emergent laparoscopic appendectomy (LA) is mandatory. The Japanese government uses a universal health insurance system. Any physician and institution can routinely perform expensive emergent LA in Japan, in accordance with medical ethics. Unsafe, but cost-effective, treatments such as interval/delayed appendectomy and conservative management only are unsuitable in Japan. Time-honored practices, (i.e., emergent LA) should be respected in Japan.