Endoscopic retrograde appendicitis therapy: Progress in clinical application

Abstract

Appendicitis is the most common abdominal surgery emergency across the globe, and one of the main reasons considered is the obstruction of appendix, primarily induced by fecal stones. With a growing appeal for treating appendicitis with appendix retain, endoscopic retrograde appendicitis therapy (ERAT) emerges as the times dictates, which is a new method to diagnose and treat appendicitis. It has been confirmed that compared with not only conservative medical treatment but also appendectomy, ERAT has outstanding advantages in treating acute uncomplicated appendicitis and appendiceal abscess. Meanwhile, there are some cases about ERAT in other types of appendicitis, such as perforating appendicitis, stump appendicitis and chronic appendicitis. This paper aims at summarizing the current progress of ERAT for doctors to use in clinical practice.

Keywords: Endoscopic retrograde appendicitis therapy; Acute uncomplicated appendicitis; Appendiceal abscess; Perforating appendicitis; Stump appendicitis

Core Tip: Endoscopic retrograde appendicitis therapy (ERAT) is a feasible, safe, and economical alternative treatment of acute uncomplicated appendicitis, even complicated appendicitis can be an indication of ERAT and the contraindications to ERAT may just be patients who are unable to routine colonoscopy. The potential risk of ERAT is recurrence due to the retain of appendix, which needs more observation. Further research, such as prospective multicenter randomized clinical trials, is necessary to determine the effectiveness and safety of ERAT in various types of appendicitis.