SynthesisSurgical endoscopy2025
Feasibility and effectiveness of endoscopic retrograde appendicitis therapy for uncomplicated acute appendicitis: a systematic review and meta-analysis.
Synthesis in Surgical endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Endoscopic direct-vision therapy vs. antibiotics for acute uncomplicated appendicitis: a retrospective cohort study.International journal of colorectal disease · 2026Article
- Simple water infusion via a non-traumatic tube facilitates endoscopic resection of an appendiceal-orifice polyp.Endoscopy · 2026Article
- Digital cholangioscope-assisted endoscopic direct-vision appendicitis therapy versus laparoscopic appendectomy for chronic appendicitis: a multicenter retrospective cohort study.Therapeutic advances in gastroenterology · 2026Article
- Evaluation of computed tomography (CT) appendicitis score and laboratory parameters in acute appendicitis with and without CT-detected appendicolith.Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES · 2025Article
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Authors and funding
5 authors.
Funding
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Abstract
backgroundAcute appendicitis is a prevalent abdominal emergency, with appendectomy and antibiotic therapy being the conventional mainstays of treatment. Recently, endoscopic retrograde appendicitis therapy (ERAT) has emerged as a promising minimally invasive alternative. This study aims to evaluate the feasibility and effectiveness of ERAT in the management of uncomplicated acute appendicitis.
methodsA systematic review of the literature was performed by searching the PubMed, Embase, Web of Science, and Cochrane Library databases, covering records from inception to January 2025. Meta-analyses were conducted using Review Manager 5.4, employing a random-effects model when applicable.
resultsA total of 8 studies were included, consisting of three randomized controlled trials and five retrospective studies, with a combined sample size of 2005 participants. When compared with the laparoscopic appendectomy (LA) group, the ERAT group demonstrated a significantly lower treatment success rate (odds ratio [OR] 0.15, 95% confidence interval [CI] 0.04-0.57, P = 0.005) and a significantly higher recurrence rate (OR 7.68, 95% CI 2.32-25.46, P = 0.0009). In contrast, compared with the antibiotic therapy group, the ERAT group exhibited a higher treatment success rate (OR 2.10, 95% CI 0.95-4.64, P = 0.07) and a lower recurrence rate (OR 0.31, 95% CI 0.09-1.07, P = 0.06), although these differences did not reach statistical significance. Additionally, the overall incidence of adverse events associated with ERAT was significantly lower than that observed with antibiotic therapy (OR 0.09, 95% CI 0.02-0.50, P = 0.005).
conclusionERAT is a promising but not yet definitive alternative for uncomplicated acute appendicitis, with advantages in organ preservation and fewer adverse events compared to antibiotics. However, relatively low success rate and high recurrence rate of ERAT currently prevent it from completely replacing appendectomy. Further high-quality studies are needed to better define its role in clinical practice.
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