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Higher Rates of New Colon Neoplasm in Interval vs. Primary Appendectomies-A Coarsened Exact Matching Analysis.

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Patients undergoing interval appendectomy have a higher risk of developing right colon or appendix cancer. However, they experience fewer postoperative complications compared to primary appendectomy patients.

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Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Epidemiology

Background:

  • Appendectomy is a common surgical procedure.
  • Interval appendectomy (IA) is performed after an initial non-operative management of appendicitis.
  • The oncological outcomes of IA compared to primary appendectomy are not well-established.

Purpose of the Study:

  • To compare the incidence of new primary right colon neoplasms between IA and primary appendectomy cohorts.
  • To compare postoperative complication rates between IA and primary appendectomy cohorts.

Main Methods:

  • Retrospective cohort study (2001-2020) using TriNetX data from 92 healthcare organizations.
  • Patients were categorized into primary appendectomy (0-14 days) and IA (15-90 days) cohorts.
  • 1:1 matching using Coarsened Exact Matching (CEM) for demographics; oncological outcomes and complications identified via ICD/CPT codes.

Main Results:

  • The IA cohort (n=2803) showed a 3.07 times higher incidence of malignant neoplasm of the right colon and appendix (p<0.001).
  • The IA cohort experienced 2.63 times lower postoperative complication rates (p<0.001).

Conclusions:

  • Interval appendectomy is associated with a significantly increased risk of right-sided neoplasms.
  • Further research is needed to establish optimal cancer screening protocols for IA patients.