ArticleBMC surgery2026
Effectiveness of protocol-based medical treatment in selected uncomplicated acute appendicitis: a retrospective cohort study.
Article in BMC surgery, 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
objectiveTo describe the short-term treatment outcomes and intermediate-term appendectomy rates following protocol-based medical treatment in carefully selected patients with uncomplicated acute appendicitis without appendicolith.
methodsThis single-arm retrospective cohort study was conducted at a single tertiary center. Patients with uncomplicated acute appendicitis without appendicolith on computed tomography (CT) were treated following a standardized protocol consisting of intravenous antibiotics, a 48-hour in-hospital observation period, and systematic follow-up. The primary outcome was treatment success during initial hospitalization, defined as symptom resolution and discharge without the need for appendectomy. Secondary outcomes included appendectomy rates and complications during the follow-up period.
resultsSixty-eight patients received protocol-based medical treatment. All 68 patients (100%) completed initial hospitalization successfully without requiring appendectomy. During a median follow-up of 2.8 years, six patients (8.8%) underwent appendectomy; however, only one of these (1.5%) represented true symptomatic recurrence, while the remaining five (7.4%) underwent surgery for non-clinical reasons including patient preference, anxiety, and pregnancy-related concerns. No major complications were observed among patients managed with antibiotics.
conclusionProtocol-based medical treatment achieved complete short-term treatment success in this selected cohort of patients with uncomplicated acute appendicitis without appendicolith. The overall appendectomy rate during follow-up remained low, with true symptomatic recurrence observed in only one patient. These findings, while limited by the single-arm observational design and small sample size, supported the feasibility of this approach when combined with reliable imaging assessment, systematic patient selection, and structured follow-up.
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