Therapeutic strategy for acute appendicitis based on laparoscopic surgery.

Area of Science:

• Gastroenterology
• Surgical Innovation
• Emergency Medicine

Background:

• Treatment strategies for acute appendicitis vary.
• Laparoscopic surgery is common, but its use in complicated appendicitis remains debated.
• Conservative antibiotic treatment and interval appendectomy are alternative approaches.

Purpose of the Study:

• To evaluate a laparoscopic surgery-based treatment strategy for all appendicitis cases, including complicated appendicitis (CA).
• To assess the feasibility and outcomes of laparoscopic surgery in both uncomplicated and complicated appendicitis.

Main Methods:

• Retrospective analysis of 305 patients with acute appendicitis from January 2013 to December 2021.
• Classification into uncomplicated appendicitis (UA) and CA based on CT scans.
• Comparison of treatment courses and outcomes between UA and CA groups.

Main Results:

• Laparoscopic surgery was performed in 153 of 159 surgical cases with a 94.8% completion rate.
• No significant difference in postoperative complications between successful emergency laparoscopic surgeries.
• For complicated appendicitis, delayed surgery (≥6 days from onset) was an independent risk factor for conversion to open laparotomy (OR: 11.80).

Conclusions:

• Laparoscopic surgery is a viable and preferred approach for all appendicitis cases, including complicated appendicitis.
• Prompt surgical intervention is essential for successful laparoscopic management of complicated appendicitis.
• Delayed presentation increases the risk of conversion to open surgery in complicated appendicitis.