Long-term Outcome of Non-operative Management of Appendiceal Mass

Authors

  • Siripong Prasertsuntarasai Division of General Surgery, Department of Surgery, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
  • Supalerk Preechayuth Division of General Surgery, Department of Surgery, King Chulalongkorn Memorial Hospital, Bangkok, Thailand

Abstract

Objective: The objective of this study was to study long-term outcome of non-operative management in patients with appendiceal mass.

Material and Methods: Medical records of patients with appendiceal mass admitted to King Chulalongkorn Memorial Hospital (KCMH) during 1998-2007 were reviewed. Masses were confirmed by ultrasonography or CT scan. Data including complications and time-interval of recurrent appendicitis were obtained.

Results: Of 35 patients, 17 underwent non-operative management and 18 underwent interval appendectomy at the mean duration of 3 (1-10) months. Mean follow-up time was 40 (1-112) months. Of 17 patients with non-operative management, 4 (23.5%) had recurrent appendicitis within 6 months and underwent appendectomy. Two of these 4 patients had postoperative complications including gut obstruction and re-appendectomy. Appendicitis could not be demonstrated by pathological examination in 8 out of 18 with interval appendectomy (44%). Five of 18 patients (27%) had postoperative complications including wound infections and intraabdominal collection.

Conclusions: Non-operative management of appendiceal mass can be safely performed. Appendectomy should be reserved only when recurrent symptom occurred. Further investigation with larger population should be obtained.

References

1. Willemsen PJ, Hoorntje LE, Eddes EH, Ploeg RJ. The need for interval appendectomy after resolution of an appendiceal mass questioned. Dig Surg 2002; 19: 216-20.

2. Nitecki S, Assalia A, Schein M. Contemporary management of the appendiceal mass. Br J Surg 1993 Jan; 80(1): 18-20.

3. Tingstedt B, Bexe-Lindskog E, Ekelund M, Andersson R. Management of appendiceal masses. Eur J Surg 2002; 168: 579-82.

4. Lai HW, Loong CC, Chiu JH, Chau GY, Wu CW, Lui WY. Interval appendectomy after conservative treatment of an appendiceal mass. World J Surg 2006; 30: 352-7.

5. Okafor Pl, Orakwe JC, Chianakwana GU, Management of appendiceal masses in a peripheral hospital in Nigeria: review of thirty cases. World J Surg 2003; 27:800-3.

6. Bagi P, Dueholm s. Nonoperative management of the ultrasonically evaluated appendiceal mass. Surgery 1987; 101:602-5

7. Karaca I, Altintoprak Z, Karkiner A, Temir G, Mir E. The management of appendiceal mass in children: is interval appendectomy necessary? Surg Today 2001:31: 675-7.

8. Dixin MR, Haukoos JS, Park IU, et al. An assessment of the severity of recurrent appendicitis. Am J Surg 2003; 186:718-22

9. Corfield L. Interval appendicectomy after appendiceal mass or abscess in adults: what is "best practice"? Surg Today 2007: 37: 1-4. Epub 2007 Jan 1.

10. Ahmed I, Deakin D, Parson SL. Appendix mass: do we know how to treat it? Ann R Coll Surg Engl 2005; 87: 191-5.

11. Lai HW, Loong CC, Wu CW, Lui WY. Watchful waiting versus interval appendectomy for patients who recovered from acute appendicitis with tumor formation: a cost-effectiveness analysis. J Chin Med Assoc 2005; 68: 431-4.

Downloads

Published

2007-06-29

How to Cite

1.
Prasertsuntarasai S, Preechayuth S. Long-term Outcome of Non-operative Management of Appendiceal Mass. Thai J Surg [Internet]. 2007 Jun. 29 [cited 2024 Nov. 23];28(2):57-60. Available from: https://he02.tci-thaijo.org/index.php/ThaiJSurg/article/view/241336

Issue

Section

Original Articles