ArticleInternational journal of colorectal disease2019
Comparison of conservative versus surgical therapy for acute appendicitis with abscess in five German hospitals.
Article in International journal of colorectal disease, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.
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Who cites it
8 citing papers in PubMed, 2 syntheses or guidelines pooled it, 17 citations in OpenAlex.
- Non-operative management of appendiceal abscess in children: a systematic review.Annals of medicine · 2025Pooled it
- Acute Appendicitis in Childhood and Adulthood.Deutsches Arzteblatt international · 2020Pooled it
- Development and validation of a new scoring system to discriminate between uncomplicated and complicated appendicitis.Scientific reports · 2024Article
- Development of a scoring model based on objective factors to predict gangrenous/perforated appendicitis.BMC gastroenterology · 2023Article
- Does the presence of an appendicolith or abscess predict failure of nonoperative management of patients with acute appendicitis?Emergency radiology · 2021Article
- Laparoscopic Appendectomy: A Safe and Definitive Solution for Suspected Appendicitis.Visceral medicine · 2021Article
- [Recommendations on treatment of acute appendicitis : Recommendations of an expert group based on the current literature].Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen · 2020Review
- Validation of Nonselective Conservative Treatment for Pediatric Acute Appendicitis.Pediatrics international : official journal of the Japan Pediatric SocietyArticle
Corrections and comments
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Authors and funding
10 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe aim of this study was to evaluate the effectiveness of initially conservative therapy compared to immediate appendectomy for acute appendicitis with abscess in terms of medical and economic outcomes.
methodsOf all the patients treated for appendicitis from January 2009 to December 2017 in five German hospitals, 240 were included in the study. Fifty-three patients received conservative (CON) and 195 patients received surgical (SUR) therapy as initial treatment.
resultsLength of stay was similar (12.5 days in CON vs. 13.3 days in SUR, p = 0.530). Readmission rate was higher in the conservative group (54.7% vs. 6.2%, p < 0.001). The majority (53.7%) of the 41 operations in CON group were appendectomies (22 procedures), 1 (4.5%) of them was in the first hospital stay because of persisting symptoms, 21 (95.5%) after a recovery interval. Seven (33.3%) of the recovery appendectomies were performed due to persisting or recurrent symptoms and 14 (66.7%) due to the request of patient. Twenty-one patients (39.6%) in the CON group did not need surgery. The rates of complication-related operations per patient (0.04 versus 0.58, p < 0.001), conversions of surgical technique (1.9% vs. 34.9%, p = 0.0287), and extended resections (1.9% vs. 31.3%, p < 0.001) were higher in SUR group. Furthermore, morbidity, hospital costs, and loss in quality of life were significantly higher in the surgical group (17.0% vs. 66.2%, p < 0.001; € 5044 vs. € 8457, p < 0.001, and 4.3 days vs. 7.5 days, p < 0.001, CON vs. SUR).
conclusionInitially, conservative treatment for acute appendicitis with abscess is preferable to immediate surgical treatment in reduction of morbidity, hospital costs, and loss in quality of life.
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