Sakorafas GH, Sabanis D, Lappas C, Mastoraki A, Papanikolaou J, Siristatidis C, Smyrniotis V. Interval routine appendectomy following conservative treatment of acute appendicitis: Is it really needed. World J Gastrointest Surg 2012; 4(4): 83-86 [PMID: 22590661 DOI: 10.4240/wjgs.v4.i4.83]
Corresponding Author of This Article
George H Sakorafas, MD, Assistant Professor, 4th Department of Surgery, Athens University, Medical School, Attikon University Hospital, Arkadias 19-21, GR-115 26 Athens, Greece. georgesakorafas@yahoo.com
Article-Type of This Article
Editorial
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World J Gastrointest Surg. Apr 27, 2012; 4(4): 83-86 Published online Apr 27, 2012. doi: 10.4240/wjgs.v4.i4.83
Interval routine appendectomy following conservative treatment of acute appendicitis: Is it really needed
George H Sakorafas, Dimitrios Sabanis, Christos Lappas, Aikaterini Mastoraki, John Papanikolaou, Charalambos Siristatidis, Vasileios Smyrniotis
George H Sakorafas, Dimitrios Sabanis, Christos Lappas, Aikaterini Mastoraki, Vasileios Smyrniotis, 4th Department of Surgery, Athens University, Medical School, Attikon University Hospital, GR-115 26 Athens, Greece
John Papanikolaou, Department of Gastroenterology, Athens University, Medical School, Attikon University Hospital, GR-115 26 Athens, Greece
Charalambos Siristatidis, Department of Obstetrics and Gynecology, Athens University, Medical School, Attikon University Hospital, GR-115 26 Athens, Greece
Author contributions: Sakorafas GH designed and wrote the paper; Sabanis D, Lappas C and Mastoraki A performed the literature research; Papanikolaou J and Siristatidis C analyzed bibliographical data; Smyrniotis V edited the paper.
Correspondence to: George H Sakorafas, MD, Assistant Professor, 4th Department of Surgery, Athens University, Medical School, Attikon University Hospital, Arkadias 19-21, GR-115 26 Athens, Greece. georgesakorafas@yahoo.com
Telephone: +30-210-7487192 Fax: +30-210-7487192
Received: January 9, 2011 Revised: March 24, 2012 Accepted: March 30, 2012 Published online: April 27, 2012
Abstract
Conservative management of acute appendicitis (AA) is gradually being adopted as a valuable therapeutic choice in the treatment of selected patients with AA. This approach is based on the results of many recent studies indicating that it is a valuable and effective alternative to routine emergency appendectomy. Existing data do not support routine interval appendectomy following successful conservative management of AA; indeed, the risk of recurrence is low. Moreover, recurrences usually exhibit a milder clinical course compared to the first episode of AA. The role of routine interval appendectomy is also questioned recently, even in patients with AA complicated by plastron or localized abscess formation. Surgical judgment is required to avoid misdiagnosis when selecting a conservative approach in patients with a presumed “appendiceal” mass.