SynthesisWorld journal of emergency surgery : WJES2017
The current management of acute uncomplicated appendicitis: should there be a change in paradigm? A systematic review of the literatures and analysis of treatment performance.
Synthesis in World journal of emergency surgery : WJES, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 50 citations in OpenAlex.
- The SIFIPAC/WSES/SICG/SIMEU guidelines for diagnosis and treatment of acute appendicitis in the elderly (2019 edition).World journal of emergency surgery : WJES · 2020Guideline
- MELD score is predictive of postoperative morbidity and mortality in patients with acute appendicitis undergoing appendectomy: ACS-NSQIP data analysis.Surgical endoscopy · 2026Article
- Value of Early Kinetics of Procalcitonin with Point-of-Care Test to Predict Postoperative Abscess Following Non-Complicated Acute Appendicitis: A Pilot Study.Medicina (Kaunas, Lithuania) · 2025Article
- Article
- Indication of conservative treatment by antibiotics for uncomplicated and complicated acute appendicitis.World journal of gastrointestinal surgery · 2024Article
- Review
- Clips closure versus endoloop ligation in laparoscopic appendectomy: a systematic review and meta-analysis of comparative studies.Annals of medicine and surgery (2012) · 2023Review
- Characteristics of Patients Presented with Complicated Appendicitis in Adama, Ethiopia: A Cross-Sectional Study.Open access emergency medicine : OAEM · 2022Article
- Sensitivity and specificity of the Alvarado Score for the timely differential diagnosis of acute appendicitis for a case series in Samoa.Annals of medicine and surgery (2012) · 2022Article
- Antibiotics as first-line alternative to appendicectomy in adult appendicitis: 90-day follow-up from a prospective, multicentre cohort study.The British journal of surgery · 2021Observational
- Cost-effectiveness analysis of nonoperative management versus open and laparoscopic surgery for uncomplicated acute appendicitis in Colombia.Cost effectiveness and resource allocation : C/E · 2021Article
- An asymptomatic detachment of the appendix evolved to giant abscess and complete colliquative necrosis: pivotal role of computed tomography in patient management.BJR case reports · 2021Article
- The management of adult appendicitis during the COVID-19 pandemic: an interim analysis of a UK cohort study.Techniques in coloproctology · 2021Article
- Nonoperative Antibiotic Treatment of Appendicitis in Adults: A Survey among Clinically Active Surgeons.Visceral medicine · 2020Article
- Laparoscopic versus open approach for diffuse peritonitis from appendicitis ethiology: a subgroup analysis from the Physiological parameters for Prognosis in Abdominal Sepsis (PIPAS) study.Updates in surgery · 2020Article
- Risk factors for serious morbidity, prolonged length of stay and hospital readmission after laparoscopic appendectomy - results from Pol-LA (Polish Laparoscopic Appendectomy) multicenter large cohort study.Scientific reports · 2019Article
- Observational
- Medical Treatment: An Emerging Standard in Acute Appendicitis?Nigerian medical journal : journal of the Nigeria Medical AssociationReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionAppendectomy has long been the mainstay of intervention for acute appendicitis, aiming at preventing perforation, peritonitis, abscess formation and recurrence. With better understanding of the disease process, non-operative management (NOM) with antibiotics alone has been proved a feasible treatment for uncomplicated appendicitis. This article aimed at systematically reviewing the available literatures and discussing the question whether NOM should replace appendectomy as the standard first-line treatment for uncomplicated appendicitis.
methodA search of the Embase, Pubmed and Cochrane Library was performed using the keywords 'acute appendicitis' and 'antibiotic therapy'. Meta-analysis with inverse variance model for continuous variable and Mantel Haenzel Model for dichotomous variable was performed to evaluate the one year treatment efficacy, morbidities rate, sick leave duration and length of hospital stay associated with emergency appendectomy and NOM.
resultsSix randomized control trials were identified out of 1943 publications. NOM had a significant lower treatment efficacy rate at one year, 0.10 (95% CI 0.03-0.36,
conclusionThe paradigm remains unchanged, that appendectomy is the gold standard of treatment for uncomplicated appendicitis, given its higher efficacy rate when compared to NOM.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.