ArticleInternational journal of colorectal disease2026
Endoscopic direct-vision therapy vs. antibiotics for acute uncomplicated appendicitis: a retrospective cohort study.
Article in International journal of colorectal disease, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundEndoscopic direct-vision appendicitis therapy (EDAT) is an emerging ultra-minimally invasive technique for acute uncomplicated appendicitis (AUA). Its comparative effectiveness against antibiotic therapy remains unclear. PURPOSE: To compare short-term outcomes and recurrence rates of EDAT versus antibiotic therapy in AUA.
methodsThis retrospective cohort study included 92 AUA patients (41 EDAT, 51 antibiotics). Outcomes included symptom relief, hospital stay, inflammatory markers, treatment success, and recurrence. Subgroup analyses were performed based on fecalith presence and baseline inflammation severity.
resultsBaseline characteristics were comparable between groups (all P > 0.05), except for a significantly higher prevalence of fecaliths in the EDAT group (43.9% vs. 21.6%, P = 0.022). EDAT was associated with significantly faster abdominal pain relief [median 12.0 (IQR 12.0-24.0) h vs. 24.0 (12.0-36.0) h, P = 0.008], shorter hospital stay [3.0 (2.0-3.5) days vs. 4.0 (3.0-5.0) days, P < 0.001], and lower postoperative inflammatory markers (WBC =6.83 ± 1.39 vs. 8.53 ± 1.87 × 10
conclusionIn selected patients with AUA, EDAT offers faster symptom resolution, better early inflammatory control, and significantly lower recurrence rates compared with antibiotic therapy. The presence of fecaliths and elevated baseline CRP predicts a higher risk of antibiotic failure, suggesting that EDAT may be particularly valuable in these subgroups. Further prospective studies are warranted to clarify the role of EDAT relative to surgical appendectomy.
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