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Appendiceal mass: conservative therapy followed by interval laparoscopic appendectomy

H I Vargas1, A Averbook, M J Stamos

  • 1Harbor UCLA Medical Center, Torrance 90509.

The American Surgeon
|October 1, 1994
PubMed
Summary

Conservative management and interval laparoscopic appendectomy (ILA) are safe and effective for appendiceal abscess or phlegmon. This approach leads to successful outcomes with minimal complications and rapid recovery for patients.

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Area of Science:

  • Gastroenterology
  • Surgical Innovation
  • Abdominal Surgery

Background:

  • Appendiceal abscess and phlegmon management is evolving.
  • Key debates involve conservative therapy, abscess drainage, and interval appendectomy.
  • Current treatment strategies require further evaluation for optimal patient outcomes.

Purpose of the Study:

  • To assess the safety and efficacy of conservative treatment for appendiceal abscess/phlegmon.
  • To evaluate the effectiveness of interval laparoscopic appendectomy (ILA) as a subsequent treatment.
  • To provide evidence-based recommendations for managing appendiceal abscess and phlegmon.

Main Methods:

  • Retrospective analysis of patients with appendiceal abscess/phlegmon.
  • Initial treatment included antibiotics and, in some cases, percutaneous drainage.

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  • Interval laparoscopic appendectomy (ILA) was performed 6–12 weeks post-initial therapy.

    • Main Results:

    • Twelve patients were included; 4 with phlegmon, 8 with abscess.
    • All patients initially improved with conservative management; 4 underwent percutaneous drainage.
    • ILA succeeded in 11 of 12 patients, with a median 1-day hospital stay and no perioperative morbidity.

    Conclusions:

    • Initial conservative management of appendiceal abscess/phlegmon is safe and effective.
    • Interval laparoscopic appendectomy (ILA) is a safe and effective procedure.
    • This combined approach offers a viable treatment strategy for appendiceal abscess/phlegmon.