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Review
. 2022 Aug;54(8):747-754.
doi: 10.1055/a-1737-6381. Epub 2022 Mar 7.

Endoscopic retrograde appendicitis therapy versus laparoscopic appendectomy for uncomplicated acute appendicitis

Baohong Yang  1   2 , Lingjian Kong  1 , Saif Ullah  1 , Lixia Zhao  1 , Dan Liu  1 , Deliang Li  1 , Xuezhong Shi  3 , Xiaocan Jia  3 , Paras Dalal  4 , Bingrong Liu  1
Affiliations
Review

Endoscopic retrograde appendicitis therapy versus laparoscopic appendectomy for uncomplicated acute appendicitis

Baohong Yang et al. Endoscopy. 2022 Aug.

Abstract

Background: Endoscopic retrograde appendicitis therapy (ERAT) is a new and minimally invasive technique for the treatment of acute appendicitis. This study aimed to assess the efficacy and clinical outcomes of ERAT versus laparoscopic appendectomy for patients with uncomplicated acute appendicitis.

Methods: We adopted propensity score matching (1:1) to compare ERAT and laparoscopic appendectomy in patients with uncomplicated acute appendicitis between April 2017 and March 2020. We reviewed 2880 patients with suspected acute appendicitis, of whom 422 patients with uncomplicated acute appendicitis met the matching criteria (ERAT 79; laparoscopic appendectomy 343), yielding 78 pairs of patients.

Results: The rate of curative treatment within 1 year after ERAT was 92.1 % (95 % confidence interval [CI] 83.8 % to 96.3 %). The percentage of patients recording visual analog scale values of ≤ 3 for pain at 6 hours after treatment was 94.7 % (95 %CI 87.2 % to 97.9 %) in the ERAT group, which was significantly higher than that in the laparoscopic appendectomy group (83.3 %; 95 %CI 73.5 % to 90.0 %). Median procedure time and median hospital length of stay were significantly lower in the ERAT group compared with the laparoscopic appendectomy group. At 1 year, the median recurrence time was 50 days (interquartile range 25-127) in the ERAT group. The overall adverse event rate was 24.4 % (95 %CI 14.8 % to 33.9 %) in the laparoscopic appendectomy group and 18.4 % (95 %CI 9.7 % to 27.1 %) in the ERAT group, with no significant difference between the two groups.

Conclusion: ERAT was a technically feasible method of treating uncomplicated acute appendicitis compared with laparoscopic appendectomy.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
The endoscopic retrograde appendicitis therapy (ERAT) procedure. a Appendiceal orifice. b Appendiceal lumen cannulation. c Filling defect in the appendiceal lumen visible on imaging (red arrows). d Flushing out of pus or appendiceal fecal stone. e Stent placement. f Radiograph after ERAT (red arrow indicates the stent).
Fig. 2
Fig. 2
Flow diagram of the entire and matched cohorts.
Fig. 3
Fig. 3
Kaplan–Meier graph for time to recurrence after endoscopic retrograde appendicitis therapy at 1-year follow-up.
See this image and copyright information in PMC

Comment in

References

    1. Humes D J, Simpson J. Acute appendicitis. BMJ. 2006;333:530–534. - PMC - PubMed
    1. Harris C W. Abraham Groves of Fergus: the first elective appendectomy? Can J Surg. 1961;4:405–410. - PubMed
    1. Semm K. Endoscopic appendectomy. Endoscopy. 1983;15:59–64. - PubMed
    1. Poprom N, Numthavaj P, Wilasrusmee C et al. The efficacy of antibiotic treatment versus surgical treatment of uncomplicated acute appendicitis: systematic review and network meta-analysis of randomized controlled trial. Am J Surg. 2019;218:192–200. - PubMed
    1. Liu B R, Song J T, Han F Y et al. Endoscopic retrograde appendicitis therapy: a pilot minimally invasive technique (with videos) Gastrointest Endosc. 2012;76:862–866. - PubMed