Endoscopic retrograde appendicitis therapy versus laparoscopic appendectomy versus open appendectomy for acute...

Area of Science:

• Gastroenterology
• Surgical Innovation
• Clinical Trials

Background:

• Acute uncomplicated appendicitis is commonly treated surgically.
• Endoscopic retrograde appendicitis therapy (ERAT) has shown potential benefits.
• Prospective controlled studies evaluating ERAT are lacking.

Purpose of the Study:

• To assess the feasibility and safety of ERAT for acute uncomplicated appendicitis.
• To compare ERAT with laparoscopic appendectomy (LA) and open appendectomy (OA).

Main Methods:

• An open-label, randomized controlled trial was conducted.
• 99 patients were allocated to ERAT, LA, or OA groups (33 per group).
• Clinical success rate was the primary outcome, analyzed using intention-to-treat.

Main Results:

• Clinical success rates were 87.88% for ERAT, 96.97% for LA, and 100% for OA.
• No significant differences in clinical success (P=0.123) or adverse events (P=0.693) were observed between groups.
• The ERAT to surgery crossover rate was 21.21%.

Conclusions:

• ERAT is a feasible and efficient alternative treatment for acute uncomplicated appendicitis.
• ERAT offers a viable option alongside traditional surgical approaches.
• Further research may explore optimizing ERAT techniques and patient selection.