Interval Appendectomy after Conservative Treatment of an Appendiceal Mass

• Published in: World journal of surgery 2006-03, Vol.30 (3), p.351-357
• Main Authors: Lai, Hung‐Wen, Loong, Che‐Chuan, Chiu, Jen‐Hwey, Chau, Gar‐Yang, Wu, Chew‐Wun, Lui, Wing‐Yui
• Format: Article
• Language: English
• Subjects: Acute Appendicitis; Adolescent; Adult; Aged; Aged, 80 and over; Appendectomy - methods; Appendiceal Neoplasms - diagnosis; Appendiceal Neoplasms - surgery; Appendiceal Neoplasms - therapy; Appendicitis; Appendicitis - diagnosis; Appendicitis - surgery; Appendicitis - therapy; Barium Enema; Barium Sulfate; Biological and medical sciences; Chi-Square Distribution; Child; Colonoscopy; Colorectal Neoplasms - diagnosis; Conservative Treatment; Contrast Media; Diagnosis, Differential; Enema; Female; General aspects; Humans; Interval Appendectomy; Male; Medical sciences; Middle Aged; Postoperative Complications; Recurrence; Retrospective Studies; Stomach, duodenum, intestine, rectum, anus; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Treatment Outcome
• ISSN: 0364-2313; 1432-2323
• DOI: 10.1007/s00268-005-0128-4

Introduction The purpose of this study was to clarify the role of interval appendectomy after conservative treatment of an appendiceal mass. Methods From January 1998 to December 2003, patients with an appendiceal mass who received conservative treatment at the Taipei Veterans General Hospital were studied retrospectively. Data on demographics, rate of appendicitis recurrence, duration of hospital stay, and complication rate were collected and analyzed. Results A total of 165 patients were included (89 males, 76 females). The mean age was 53.6 years (range 7–89 years). The rate of appendicitis recurrence after conservative treatment was 25.5%; most recurred within 6 months after discharge (83.3%). The benefit of preventing recurrence is less than 16% if interval appendectomy is performed 6 weeks after discharge and less than 10% if it is done 12 weeks later. The complication rate of appendectomy performed before or after recurrence was 10% in both groups. The duration of the second hospital stay for patients who underwent interval appendectomy before or after recurrence was 4.43 ± 3.32 vs. 6.75 ± 5.73 days (P = 0.023). Of the 165 patients, 17 (10.3%) had their diagnosis changed after survey or surgery, and 5 (3.03%) were found to have colon cancer upon follow‐up. Conclusions Patients who recovered from conservative treatment of an appendiceal mass should undergo colonoscopy or barium enema to detect any underlying diseases and to rule out coexistent colorectal cancer. Routine interval appendectomy benefits less than 20% of patients.