Top line:
Most patients receive antibiotics rather than surgical treatment. appendicitis Long-term results are good, but surgery may be required after up to 20 years.
methodology:
- Follow-up of 292 patients who participated in two randomized controlled trials conducted by the Swedish National Patient Registry in the 1990s.
- Both trials divided patients into two groups. appendectomy People who have been treated with antibiotics for appendicitis.
- Researchers looked at the rate of recurrence of appendicitis requiring surgery later in life.
remove:
- Twenty-nine percent of patients in the nonsurgical group who were discharged successfully during the initial study ultimately underwent surgery.
- Some patients initially given antibiotics have required surgery up to 20 years later.
- 9.5% of patients who did not undergo surgery visited the surgical outpatient clinic for abdominal pain, compared with 0.01% of patients who underwent surgery.
in fact:
“More than half of patients treated non-operatively experienced no recurrence and avoided surgery for approximately 20 years. There is no evidence of long-term risks of non-operative management other than recurrence of appendicitis.” have reported.
sauce:
Dr Simon Eaton, from UCL Great Ormond Street Institute of Child Health in London, is the corresponding author of the study. Published online Today is JAMA surgery. The research was funded by his NIHR Biomedical Research Center at Great Ormond Street Hospital and the Swedish Research Council.
Limitations:
Because the data were retrospective, the researchers were unable to track how patients’ conditions and characteristics changed over time. Most patients were male, and the researchers lacked histopathology results for patients who initially received successful nonsurgical treatment but later required appendectomy. They also relied on diagnostic criteria used in his 1990s, when the first studies were conducted. These were less sophisticated and less accurate than modern standards.
Disclosure:
Co-author Jan Svensson, MD, reported receiving a grant from the Lovisa Foundation during the conduct of the study. No other disclosures were reported.
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