Reduced recurrence rate with a targeted approach in uncomplicated appendicitis treated with endoscopic direct vs retrograde therapy

Table 1 Patients’ characteristics at baseline, n (%)

	EDAT (n = 136)	ERAT (n = 34)	P value1
Clinical characteristics
Age, years	33.0 (19.5-46.0)	35.5 (27.0-49.0)	0.251
Sex, male	77 (56.6)	20 (58.8)	0.816
Symptoms
Vomiting/nausea	26 (19.1)	11 (32.4)	0.094
RLQ abdominal pain	119 (87.5)	26 (76.5)	0.104
Fever	21 (15.4)	6 (17.6)	0.753
Laboratory characteristics
WBC, × 109/L2	7.4 (5.9-10.8)	7.2 (5.1-9.5)	0.431
Neutrophils proportion > 75%	41 (31.8)	10 (29.4)	0.791
Serum hs-CRP3, mg/L	5.1 (0.6-28.8)	9.2 (2.2-21.4)	0.391
Imaging test
Computed tomography	115 (84.6)	32 (94.1)	0.145
Ultrasonography	125 (91.9)	32 (94.1)	0.665

¹For group comparison, a two-sample t-test was used for continuous variables, and χ² tests were used for categorical variables.

²A value between 3.5 × 10⁹/L and 9.5 × 10⁹/L was considered within the normal limit.

³A value between 0 mg/dL and 6 mg/dL was considered within the normal limit.

Continuous data are displayed as medians (interquartile ranges). Hs-CRP: High-sensitive C-reactive protein; EDAT: Endoscopic direct appendicitis therapy; ERAT: Endoscopic retrograde appendicitis therapy; RLQ: Right lower quadrant; WBC: White blood cell.

Table 2 Comparison outcomes and lesion characteristics of the two groups, n (%)

	EDAT (n = 136)	ERAT (n = 34)	P value1
Outcomes
Intervention success	135 (99.3)	28 (82.4)	< 0.001a
Guide-wire assistance2	48 (35.3)	34 (100.0)	< 0.001a
Stent deployment	13 (9.6)	26 (76.5)	< 0.001a
Colonoscopic view of appendiceal orifice
Edematous/inflammatory	105 (81.8)	22 (66.7)	0.209
Pus exudate	39 (28.7)	10 (31.3)	0.773
Appendiceal content3
Appendicolith	75 (55.6)	22 (73.3)	0.074
Pus	55 (40.7)	18 (60.0)	0.055
Lumen stricture	21 (15.6)	7 (23.3)	0.385
Unable to identify	0 (0)	4 (11.8)	N/A
Appendicoscopic view of appendiceal mucosa4
Smooth	7 (5.3)	N/A	N/A
Erosive	115 (85.2)	N/A	N/A

^aP < 0.05 significant.

¹For group comparison, a two-sample t-test was used for continuous variables, and χ² tests were used for categorical variables.

²Guidewire-assisted endoscopic direct appendicitis therapy (EDAT) intubation or endoscopic retrograde appendicitis therapy (ERAT) canulation.

³By direct-view approach in EDAT while by indirect fluoroscopic images in ERAT.

⁴Pertient only to EDAT direct-view approach.

Continuous data are displayed as medians (interquartile ranges). EDAT: Endoscopic direct appendicitis therapy; ERAT: Endoscopic retrograde appendicitis therapy; N/A: Not applicable.