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Appendectomy

Surgery to remove the appendix (small finger-shaped pouch at the end of the first part of the large intestine).

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(Source: NIH - National Cancer Institute)

What works? Research summarized

Evidence reviews

Antibiotic therapy compared to appendectomy in the treatment of acute appendicitis.

Acute appendicitis is one of the most common surgical causes of acute abdominal pain. Appendectomy is the treatment of choice, however surgical complications are inherent to operative treatment. Recent research on primary antibiotic therapy (without surgery) reported good results.

Currently there is no evidence available from randomised control trials to determine whether Single Incision Laparoscopic Surgery provides any better effect than Conventional Multi‐incision Laparoscopic Surgery for appendicectomy.

Laparoscopic appendicectomy is used in treating appendicitis and can be achieved using several skin incisions in the abdominal wall, or more recently with a single skin incision through which instruments are introduced into the peritoneal cavity. Since no randomised control trials of single incision versus conventional multi‐incision laparoscopic surgery for appendicectomy could be found, the efficacy and safety of the two approaches could not be analysed in this review. There is a need for randomised control trials of single incision laparoscopic appendicectomy for appendicitis.

Drain use after an open appendectomy for complicated appendicitis

Appendicitis refers to inflammation of the appendix. Appendectomy, the surgical removal of the appendix, is performed primarily in patients who have acute appendicitis. Patients undergoing an appendectomy for complicated appendicitis, which is defined as gangrenous (soft‐tissue death) or perforated (burst) appendicitis, are more likely to suffer from postoperative complications. The routine placement of a surgical drain to prevent intra‐peritoneal abscess (a localised collection of pus in the abdomen or pelvis) after an appendectomy for complicated appendicitis is controversial.

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Summaries for consumers

Antibiotic therapy compared to appendectomy in the treatment of acute appendicitis.

Acute appendicitis is one of the most common surgical causes of acute abdominal pain. Appendectomy is the treatment of choice, however surgical complications are inherent to operative treatment. Recent research on primary antibiotic therapy (without surgery) reported good results.

Currently there is no evidence available from randomised control trials to determine whether Single Incision Laparoscopic Surgery provides any better effect than Conventional Multi‐incision Laparoscopic Surgery for appendicectomy.

Laparoscopic appendicectomy is used in treating appendicitis and can be achieved using several skin incisions in the abdominal wall, or more recently with a single skin incision through which instruments are introduced into the peritoneal cavity. Since no randomised control trials of single incision versus conventional multi‐incision laparoscopic surgery for appendicectomy could be found, the efficacy and safety of the two approaches could not be analysed in this review. There is a need for randomised control trials of single incision laparoscopic appendicectomy for appendicitis.

Drain use after an open appendectomy for complicated appendicitis

Appendicitis refers to inflammation of the appendix. Appendectomy, the surgical removal of the appendix, is performed primarily in patients who have acute appendicitis. Patients undergoing an appendectomy for complicated appendicitis, which is defined as gangrenous (soft‐tissue death) or perforated (burst) appendicitis, are more likely to suffer from postoperative complications. The routine placement of a surgical drain to prevent intra‐peritoneal abscess (a localised collection of pus in the abdomen or pelvis) after an appendectomy for complicated appendicitis is controversial.

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See Also: Appendicitis

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