Appendicectomy approach: Do we choose based on gender and time of day?

Appendectomy Skin Closure Technique, Randomized Controlled Trial: Changing Paradigms (ASC)

“…These management variations include the emergency (less than 8 h after presentation) versus urgent treatment (more than 8 h after presentation), questions about the safety of performing surgery during night or waiting until the morning, medical treatment with antibiotics in uncomplicated cases, interval appendectomy after medical treatment, endoscopic management, use or not of drains, and laparoscopic versus open approach to mention some of them, with some showing promising results and World J Surg others being excluded after some follow-up studies [10,[13][14][15][16][25][26][27][28][29][30][31][32][33][34][35][36][37]. It has been confirmed that appendicitis could be treated as an urgent surgery and no an emergency one, and that medical team could wait to perform surgery until the morning, starting with medical treatment, without increasing the complications rate; that more than 30 % of pure medical treatment failures represent a high risk and higher medical attention cost over surgery; that endoscopic management has not been extensively evaluated and still needs to be studied in detail.…”

“…In the last 50 years, acute appendicitis treatment had acquired plenty of possibilities, some of them proposed and accepted initially, others have been excluded after a period of time, and many of them are actually in evaluation by many researchers. These management variations include the emergency (less than 8 h after presentation) versus urgent treatment (more than 8 h after presentation), questions about the safety of performing surgery during night or waiting until the morning, medical treatment with antibiotics in uncomplicated cases, interval appendectomy after medical treatment, endoscopic management, use or not of drains, and laparoscopic versus open approach to mention some of them, with some showing promising results and others being excluded after some follow-up studies [10,[13][14][15][16][25][26][27][28][29][30][31][32][33][34][35][36][37].…”

“…It has been confirmed that appendicitis could be treated as an urgent surgery and no an emergency one, and that medical team could wait to perform surgery until the morning, starting with medical treatment, without increasing the complications rate; that more than 30 % of pure medical treatment failures represent a high risk and higher medical attention cost over surgery; that endoscopic management has not been extensively evaluated and still needs to be studied in detail. Laparoscopic surgery represents a feasible and safe technique, with the lower wound infection rate, length of hospital stay, less postoperative pain, and better results in obese patients but a higher incidence of intra-abdominal abscess, higher cost, more equipment requirements, more training needed, and the fact that is not always available in all medical centers [10,[13][14][15][16][25][26][27][28][29][30][31][32][33][34][35][36][37]. The main reason why we perform this study is because, as in our medical center, there are still many hospitals around the world that do not have the laparoscopic option, or are not available in all shifts, allowing an area of opportunity for improvement of this technique and reducing complications.…”