Endoscopic direct-vision therapy for acute uncomplicated appendicitis: a retrospective study

Area of Science:

• Gastroenterology
• Minimally Invasive Surgery
• Surgical Innovation

Background:

• Acute uncomplicated appendicitis is a common condition requiring treatment.
• Laparoscopic appendectomy (LA) is standard but invasive; endoscopic retrograde appendicitis therapy (ERAT) involves radiation.
• Endoscopic direct-vision appendicitis therapy (EDAT) is an ultra-minimally invasive, organ-preserving approach with unclear clinical applicability and recurrence rates.

Purpose of the Study:

• To evaluate the short-term efficacy and safety of EDAT compared to LA.
• To determine the suitable patient population for EDAT.
• To contextualize EDAT within existing appendicitis treatment evidence.

Main Methods:

• A retrospective study compared 41 EDAT patients with 46 LA patients (Dec 2023-Dec 2024).
• Outcomes assessed included operation time, pain relief, oral intake resumption, inflammatory markers (WBC, CRP), and complications.
• Subgroup analyses (gender, age) and correlation analyses were performed.

Main Results:

• EDAT demonstrated significantly shorter operation times, faster pain relief, and earlier oral intake resumption than LA.
• Postoperative inflammatory markers (WBC, CRP) were significantly better controlled in the EDAT group.
• The EDAT group experienced a shorter hospital stay, with a 7.32% recurrence rate observed over a mean follow-up of 7.88 months.

Conclusions:

• EDAT is a feasible and safe ultra-minimally invasive option for selected appendicitis patients, surpassing LA in symptom relief and inflammation control.
• The study's limitations include its single-center, small-sample, and short follow-up duration.
• Large-scale, prospective studies with longer follow-up are recommended to validate EDAT's long-term efficacy and applicability.