Long-Term Complications of Appendectomy: A Systematic Review

Area of Science:

• Gastroenterology
• Surgical Outcomes
• Epidemiology

Background:

• Appendectomy is a frequent surgical procedure.
• Limited data exists on the long-term effects of appendectomy.
• A systematic review is needed to consolidate existing knowledge.

Purpose of the Study:

• To systematically review the long-term complications following appendectomy for acute appendicitis.
• To assess surgical outcomes, inflammatory bowel disease, cancer risk, fertility, and mortality.
• To provide a comprehensive overview of appendectomy's long-term consequences.

Main Methods:

• Systematic review adhering to PRISMA guidelines.
• Searched PubMed and EMBASE for studies with appendectomy and >30-day follow-up.
• Included 37 studies analyzing outcomes like ileus, incisional hernia, IBD, cancer, fertility, and mortality.

Main Results:

• Low prevalence of long-term surgical complications: ileus (1.0%) and incisional hernia (0.7%).
• Ulcerative colitis prevalence was lower (0.15% vs. 0.19%), while Crohn's disease prevalence was higher (0.20% vs. 0.12%) post-appendectomy.
• No significant cancer patterns observed; fertility rates increased, and mortality remained low.

Conclusions:

• Appendectomy demonstrates a low incidence of long-term surgical complications.
• No significant long-term adverse effects were identified, with appendectomy not impairing fertility.
• A higher prevalence of Crohn's disease and a lower prevalence of ulcerative colitis were noted after appendectomy.