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Effect of Endoscopic Retrograde Appendicitis Therapy on Postoperative Gastrointestinal Function in Patients With
Yao Wu1, Peichen Xia1, Jing Chen1
1Department of Gastroenterology, Sir Run Run Hospital, Nanjing Medical University, Nanjing, Jiangsu, China, njmu.edu.cn.
Background:
This study compared postoperative gastrointestinal function recovery between endoscopic retrograde appendicitis therapy (ERAT) and laparoscopic appendectomy (LA) in patients diagnosed with chronic fecalith appendicitis.
Methods:
This was a retrospective study enrolling patients with chronic fecalith appendicitis, who were divided into the ERAT group and the LA group. Gastrointestinal manifestations were recorded, and the Gastrointestinal Symptom Rating Scale (GSRS) score was applied to evaluate gastrointestinal function. Preoperative and postoperative symptomatic improvement and GSRS scores were compared across groups.
Result:
A total of 101 eligible patients were recruited and divided into the ERAT group (n = 40, 39.60%) and the LA group (n = 61, 60.40%). All ERAT procedures were completed successfully, with 100% rates of successful intubation and fecalith removal. No severe adverse events were reported postoperatively in either cohort. Compared with LA, ERAT presented significantly shorter operative duration and postoperative hospital stay (statistically significant differences). For GSRS score assessment, the median preoperative, postoperative scores and score reduction were 5 (4), 1 (1.75), and 3.5 (1) in the ERAT group, versus 4 (2), 3 (3), and 1 (2) in the LA group. The ERAT group exhibited a significantly larger magnitude of symptom improvement (p < 0.001, z = -5.484). Multivariate logistic regression analysis indicated that patients undergoing ERAT obtained a significantly higher degree of GSRS score improvement (p < 0.001, odds ratio = 2.137, 95% confidence interval: 1.461-3.126). Analysis of individual GSRS domains demonstrated that improvements in abdominal pain, dyspepsia and diarrhea were significantly more prominent in the ERAT group.
Conclusion:
As an organ-preserving endoscopic procedure, ERAT retains appendiceal function and protects gastrointestinal physiological function. Our findings offer meaningful clinical references of treatment strategies for chronic fecalith appendicitis.
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