ArticleDigestive diseases and sciences2026
Appendoscope-Assisted Endoscopic Retrograde Appendicitis Therapy Versus Antibiotic Monotherapy for Acute Uncomplicated Appendicitis.
Article in Digestive diseases and sciences, 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
BACKGROUND AND
aimsThis is a single-center retrospective study aiming to compare the clinical efficacy and safety of appendoscope-assisted endoscopic retrograde appendicitis therapy (ERAT) versus antibiotic monotherapy in patients with acute uncomplicated appendicitis (AUA).
methodsWe retrospectively enrolled patients diagnosed with AUA who received appendoscope-assisted ERAT or antibiotic monotherapy between July 2023 and August 2024. After exclusion and propensity score matching (PSM, 1:1), 40 matched patient pairs were included in the final analysis. The primary outcome was treatment failure within one year, defined as a composite of initial treatment failure and 1-year appendicitis recurrence. Secondary outcomes included time to abdominal pain relief, duration of antibiotic therapy, length of hospital stay, hospitalization costs, and the incidence of disease- or procedure-related adverse events.
resultsCompared with antibiotic monotherapy, ERAT was associated with a significantly lower incidence of treatment failure within one year (12.5% [5/40] vs. 42.5% [17/40]; P = 0.003) and a lower 1-year appendicitis recurrence rate (10.3% [4/39] vs. 30.3% [10/33]; P = 0.032). Although the initial treatment failure rate was lower in the ERAT group than in the antibiotic monotherapy group, the difference did not reach statistical significance (2.5% [1/40] vs. 17.5% [7/40]; P = 0.057). Additionally, ERAT significantly shortened the time to abdominal pain relief (6.0 vs. 48.0 h; P < 0.001), the duration of antibiotic therapy (2.0 vs. 5.0 days; P < 0.001), and the length of hospital stay (1.0 vs. 5.0 days; P < 0.001). However, hospitalization costs were higher in the ERAT group (10,408.6 vs. 2,868.9 CNY; P < 0.001). No disease- or procedure-related adverse events occurred in either group.
conclusionAppendoscope-assisted ERAT appears to offer a safe and effective alternative for patients with AUA who wish to avoid appendectomy. Further large-scale, multicenter prospective studies are warranted to validate its long-term efficacy and establish its future clinical application.
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