The experiences of interval appendectomy for inflammatory appendiceal mass

Abstract

Background Interval appendectomy (IA) is a common treatment of acute appendicitis (AA) with inflammatory appendiceal mass (IAM). However, the management of patients with IAM is still controversial. The aim of this study was to assess the outcomes in patients with this condition. Methods We retrospectively evaluated 244 patients with AA for their clinical characteristics and outcomes. Results Forty‐three patients had IAM at the first medical examination. The mean age was significantly younger and the C‐reactive protein level significantly higher (12.6 vs 3.1 mg/dL) in patients with IAM. Thirty‐four patients received IA, and nine received emergency appendectomy (EA). In the IA group, the diameter of the abscess was larger than in the EA group (31.4 vs 16.1 mm). The total length of hospitalization was longer in the IA group than the EA group (20.6 vs 7.0 days), although the operative time was longer in the EA group because of adhesion (101.1 vs 192.1 min). Furthermore, most IA patients received a reduced‐port appendectomy (74% vs 11%). Recurrence occurred in approximately 15% of patients awaiting IA. There were no complications in either group. Conclusions Although each treatment approach has its advantages and disadvantages, both IA and EA can be the first option for the treatment of AA with IAM.

The Histopathology of the Appendix in Children at Interval Appendectomy

“…The high percentage of recurrence, which raised to 42% when the follow-up was extended to 2 years and 34% in 3.4 years of follow-up, supported the recommendation to perform interval appendectomy in patients with appendiceal abscess treated conservatively. On the other hand, the low rate of complications in elective interval appendectomy [ 11 , 16 ], compared with the high risk of recurrence and re-hospitalization, confirmed the safety of the surgical procedure, and added more support to its appropriateness.…”