Management of Complicated Appendicitis: The Evolution from Conservative Treatment to Laparoscopic Surgery: Narrative Review Article

Authors

  • Kumar Hari Rajah Department of Surgery, Taylor’s University School of Medicine and Health Science, Subang Jaya, Selangor
  • Somanathan Menon Department of Surgery, Taylor’s University School of Medicine and Health Science, Subang Jaya, Selangor

Keywords:

Complicated appendicitis, Appendicular mass, Appendicular abscess, Appendicular phlegmon, Laparoscopic appendectomy

Abstract

The management of complicated appendicitis has always been controversial, with no consensus on the management of complicated appendicitis. Complicated appendicitis is defined as perforated appendicitis with or without abscess or phlegmon formation. The management has always been conservative with intravenous antibiotics and bed rest. The emergence of laparoscopic surgery has seen a trend in immediate or early surgery for the management of complicated appendicitis. Due to the absence of any proper guidelines for the management of this condition, the treatment is often decided by the surgeon managing the condition. We have conducted this narrative review article to investigate the current management of complicated appendicitis.

References

Skjold-Ødegaard B, Søreide K. The Diagnostic Differentiation Challenge in Acute Appendicitis: How to Distinguish between Uncomplicated and Complicated Appendicitis in Adults. Diagnostics (Basel). 2022;12(7):1724.

Di Saverio S, Podda M, De Simone B, et al. Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines. World J Emerg Surg. 2020;15(1):27.

Gorter RR, Eker HH, Gorter-Stam MA, et al. Diagnosis and management of acute appendicitis. EAES consensus development conference 2015. Surg Endosc. 2016;30(11):4668-90.

Mariage M, Sabbagh C, Grelpois G, et al. Surgeon's Definition of Complicated Appendicitis: A Prospective Video Survey Study. Euroasian J Hepatogastroenterol. 2019;9(1):1-4.

Mekakas A, Nagorni EA, Tablaridis T. Complicated Appendicitis: A Surgical Controversy Concerning Risk Factors, Diagnostic Algorithm and Therapeutic Management [Internet]. Doubts, Problems and Certainties about Acute Appendicitis. IntechOpen; 2022. Available from: http://dx.doi.org/10.5772/intechopen.97270

Zavras N, Vaos G. Management of complicated acute appendicitis in children: Still an existing controversy. World J Gastrointest Surg. 2020;12(4):129-137.

Sartelli M, Baiocchi GL, Di Saverio S, et al. Prospective Observational Study on acute Appendicitis Worldwide (POSAW). World J Emerg Surg. 2018;13:19.

Shinde N, Devani R, Baseer MA, Desai K. Study of management of appendicular abscess in children. Afr J Paediatr Surg. 2020;17(3 & 4):64-7.

Luo CC, Cheng KF, Huang CS, et al. Therapeutic effectiveness of percutaneous drainage and factors for performing an interval appendectomy in pediatric appendiceal abscess. BMC Surg. 2016;16(1):72.

Miftaroski A, Kessler U, Monnard E, et al. Two-step procedure for complicated appendicitis with perityphlitic abscess formation. Swiss Med Wkly. 2017;147:w14422.

Tingstedt B, Bexe-Lindskog E, Ekelund M, et al. Management of appendiceal masses. Eur J Surg. 2002;168(11):579-82.

Demetrashvili Z, Kenchadze G, Pipia I, et al. Management of Appendiceal Mass and Abscess. An 11-Year Experience. Int Surg. 2015 Jun;100(6):1021-5.

Kim E, Kim K, Park Y. Benefits and Reduced Hospital Costs of Direct Surgery in Perforated Appendicitis With Abscess Cost-effectiveness Analysis of Treatment Complicated Appendicitis. Surg Laparosc Endosc Percutan Tech. 2021;31(6):707-10.

Olsen J, Skovdal J, Qvist N, et al. Treatment of appendiceal mass--a qualitative systematic review. Dan Med J. 2014;61(8):A4881.

Simillis C, Symeonides P, Shorthouse AJ, et al. A meta-analysis comparing conservative treatment versus acute appendectomy for complicated appendicitis (abscess or phlegmon). Surgery. 2010;147(6):818-29.

Coccolini F, Fugazzola P, Sartelli M, et al. Conservative treatment of acute appendicitis. Acta Biomed. 2018;89(9-S):119-4.

Fugazzola P, Coccolini F, Tomasoni M, et al. Early appendectomy vs. conservative management in complicated acute appendicitis in children: A meta-analysis. J Pediatr Surg. 2019;54(11):2234-41.

Garba ES, Ahmed A. Management of appendiceal mass. Ann Afr Med. 2008;7(4):200-4.

Cunnigaiper ND, Raj P, Ganeshram P, et al. Does Ochsner-Sherren regimen still hold true in the management of appendicular mass? Ulus Travma Acil Cerrahi Derg. 2010;16(1):43-6.

Yılmaz Y, Kamer E, Acar N, et al. Approach to Appendiceal Masses Due to Acute Appendicitis: Analysis of 126 Cases. Turk J Colorectal Dis. 2020;30(2):134–7.

Elsaady A. Management of Appendicular Mass; Comparative Study between Different Modalities. Austin J Gastroenterol. 2019;6(1):1097.

van Amstel P, Sluckin TC, van Amstel T, et al. Management of appendiceal mass and abscess in children; early appendectomy or initial non-operative treatment? A systematic review and meta-analysis. Surg Endosc. 2020;34(12):5234-49.

Gavriilidis P, de'Angelis N, Katsanos K, et al. Acute Appendicectomy or Conservative Treatment for Complicated Appendicitis (Phlegmon or Abscess)? A Systematic Review by Updated Traditional and Cumulative Meta-Analysis. J Clin Med Res. 2019;11(1):56-64.

Becker P, Fichtner-Feigl S, Schilling D. Clinical Management of Appendicitis. Visc Med. 2018;34(6):453-58.

Tannoury J, Abboud B. Treatment options of inflammatory appendiceal masses in adults. World J Gastroenterol. 2013;19(25):3942-50.

Gillick J, Velayudham M, Puri P. Conservative management of appendix mass in children. Br J Surg. 2001;88(11):1539-42.

Andersson RE, Petzold MG. Nonsurgical treatment of appendiceal abscess or phlegmon: a systematic review and meta-analysis. Ann Surg. 2007;246(5):741-8.

Lietzén E, Grönroos JM, Mecklin JP, et al. Appendiceal neoplasm risk associated with complicated acute appendicitis-a population based study. Int J Colorectal Dis. 2019;34(1):39-46.

Teixeira FJR Jr, Couto Netto SDD, Akaishi EH, et al. Acute appendicitis, inflammatory appendiceal mass and the risk of a hidden malignant tumor: a systematic review of the literature. World J Emerg Surg. 2017;12:12.

Noori, IF. Is Elective Interval Appendicectomy after Successful Initial Conservative Management of Appendicular Mass Necessary?. Al-Kindy Col Med J. 2014;10(2):68-72.

Meshikhes AW. Appendiceal mass: is interval appendicectomy "something of the past"? World J Gastroenterol. 2011;17(25):2977-80.

Sakorafas GH, Sabanis D, Lappas C, et al. Interval routine appendectomy following conservative treatment of acute appendicitis: Is it really needed. World J Gastrointest Surg. 2012;4(4):83-6.

Dixon MR, Haukoos JS, Park IU, et al. An assessment of the severity of recurrent appendicitis. Am J Surg. 2003;186(6):718-22.

Al-Qahtani H, Alam MK, Al-Akeely MH, et al. Routine or selective interval appendectomy for non-surgically treated appendiceal mass. J Taibah Univ Med Sci. 2010;5(2):105-9.

Fouad D, Kauffman JD, Chandler NM. Pathology findings following interval appendectomy: Should it stay or go? J Pediatr Surg. 2020;55(4):737-741.

James IA, Druhan S, Caniano DA, et al. The Presence but not the Location of an Appendicolith Affects the Success of Interval Appendectomy in Children with Ruptured Appendicitis. Surg Sci. 2011;2(2):39-44.

González MC, Rodríguez JCB, Moore EH, et al. Predictors of recurrent appendicitis after non-operative management of children with perforated appendicitis presenting with an appendicular inflammatory mass. Arch Dis Child. 2014;99(2):154–7.

Bahram MA. Evaluation of early surgical management of complicated appendicitis by appendicular mass. Int J Surg. 2011;9(1):101-3.

Kaya B, Sana B, Eriş C, et al. Apendiküler kitlelerde erken apendektomi. Ulusal Travma Acil Cerrahi Dergisi. 2012;18(1):71–4.

Das BB, Nayak KN, Mohanty SK, et al. A Retrospective Analysis of Conservative Management Versus Early Surgical Intervention in Appendicular Lump. Cureus. 2022;14(1):e21784.

Deelder JD, Richir MC, Schoorl T, et al. How to treat an appendiceal inflammatory mass: operatively or nonoperatively? J Gastrointest Surg. 2014;18(4):641-5.

Israr S, Akhtar J, Taqvi SMRH, et al. Early Surgical Management of Appendicular Mass in Pediatric Patients. J Coll Physicians Surg Pak. 2021;31(3):302-6.

Shindholimath VV, Thinakaran K, Rao TN, et al. Laparoscopic management of appendicular mass. J Minim Access Surg. 2011;7(2):136-40.

Prasad BH, Prasanth G. Laparoscopic management of appendicular mass. Int Surg J. 2018;5(4):1259-62.

Thambidorai CR, Aman Fuad Y. Laparoscopic appendicectomy for complicated appendicitis in children. Singapore Med J. 2008;49(12):994-7.

Takami T, Yamaguchi T, Yoshitake H, et al. A clinical comparison of laparoscopic versus open appendectomy for the treatment of complicated appendicitis: historical cohort study. Eur J Trauma Emerg Surg. 2020;46(4):847-51.

Galli R, Banz V, Fenner H, et al. Laparoscopic approach in perforated appendicitis: increased incidence of surgical site infection? Surg Endosc. 2013;27(8):2928-33.

Rai R, Chui CH, Sai Prasad TR, et al. Perforated appendicitis in children: benefits of early laparoscopic surgery. Ann Acad Med Singap. 2007;36(4):277-80.

Lin HF, Lai HS, Lai IR. Laparoscopic treatment of perforated appendicitis. World J Gastroenterol. 2014;20(39):14338-47.

Garg CP, Vaidya BB, Chengalath MM. Efficacy of laparoscopy in complicated appendicitis. Int J Surg. 2009;7(3):250-2.

Al-Obaidi J H. Early appendectomy in appendicular mass. Revis Bionatura 2022;7(4):67. doi:10.21931/RB/2022.07.04.67.

Rasuli SF, Naz J, Azizi N, et al. Laparoscopic Versus Open Appendectomy for Patients with Perforated Appendicitis. Cureus. 2022;14(6):e26265.

Nazir A, Farooqi SA, Chaudhary NA, et al. Comparison of Open Appendectomy and Laparoscopic Appendectomy in Perforated Appendicitis. Cureus. 2019;11(7):e5105.

Chowdhury MZ, Farooq MAA, Rahman MAM, et al. Management of early appendicular lump in children - laparoscopic technique versus open surgery: a comparative study in low-middle income country perspective. World J Pediatr Surg. 2020;3(2):e000131.

Yu MC, Feng YJ, Wang W, et al. Is laparoscopic appendectomy feasible for complicated appendicitis? A systematic review and meta-analysis. Int J Surg. 2017;40:187-97.

Güler Y, Karabulut Z, Çaliş H, et al. Comparison of laparoscopic and open appendectomy on wound infection and healing in complicated appendicitis. Int Wound J. 2020;17(4):957-65.

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Published

2023-07-03

How to Cite

1.
Hari Rajah K, Menon S. Management of Complicated Appendicitis: The Evolution from Conservative Treatment to Laparoscopic Surgery: Narrative Review Article. Thai J Surg [Internet]. 2023 Jul. 3 [cited 2024 Nov. 6];44(2):37-45. Available from: https://he02.tci-thaijo.org/index.php/ThaiJSurg/article/view/261249

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Section

Review Articles