Interval Appendicectomy After Appendiceal Mass or Abscess in Adults: What is “Best Practice”?

Corfield, Lorraine

doi:10.1007/s00595-006-3334-2

Cited by 52 publications

(53 citation statements)

References 10 publications

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“…Advocates of immediate appendicectomy mentioned advantages of avoiding the need for readmission for interval appendicectomy, and the exclusion of other pathologies masquerading as an appendix mass. [4][5][6][7] while advocates of interval appendicectomy described the advantages of avoiding recurrence of symptoms and the misdiagnosis of an appendix mass. 8,9 They argue that interval appendicectomy is a less hazardous and less challenging operation, compared with immediate appendicectomy during the initial admission.…”

Section: Introductionmentioning

confidence: 99%

Management of appendiceal mass

Garba

Ahmed

2008

Ann Afr Med

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Background:The management of appendiceal mass is surrounded with controversy. Traditional management has been conservative, with interval appendicectomy performed weeks after the mass had resolved. This remains the most common approach at many centers in the world. Recently, an increasing number of studies have challenged this approach. This article reviews some of the controversial issues in the management of appendix mass, assesses current practice and suggests an appropriate approach for the management of appendix mass. Methods: A Medline, Pubmed and Cochrane database search were used to find such key words and combinations of: appendix, appendiceal, appendicular, interval, appendectomy, appendicectomy, mass, abscess, phlegmon, and appendicitis. Results were saved and managed by Reference manager 11. All articles were cross-referenced by the authors. Results: A conservative management is still a highly acceptable approach for appendix mass. This should be followed with interval appendicectomy especially in patients with persistent right iliac fossa pain. Conclusion:We recommend initially conservative approach to the management of appendiceal mass especially in our environment. Keywords: Appendiceal mass, appendix abscess, appendix phlegmon, appendicitis, interval appendicectomyRésumé Contexte: La prise en charge du plastron appendiculaire est entoure de controverses. Le traitement usuel a toujours été conservateur avec l'appendicectomie réalisée plusieurs semaines après la fonte de la masse. C'est l'attitude la plus commune dans la plupart des centres à travers le monde. Récemment, un nombre croissant d'études ont conteste cette approche. Cet article passe en revue certaines controverses dans la prise en charge du plastron appendiculaire, présente les pratiques actuelles, et suggère une approche appropriée de la prise en charge du plastron appendiculaire. Méthode: Une recherche dans les bases documentaires Medline, Pubmed et Cochrane ont été faites par la recherche et la combinaison des mots clés que sont: appendice, appendiculaire, intervalle, appendicectomie, masse, abcès, phlegmon et appendicite. Les résultats ont été sauvegardes et traites a l'aide de Référence Manager 11. Tous les articles ont été recoupes par les auteurs. Résultats: Un traitement conservateur est encore une approche très acceptable pour le plastron appendiculaire. Cela devrait être suivi à distance par une appendicectomie particulièrement chez les patients ayant une douleur persistante de la fosse iliaque droite. Conclusion: Nous recommandons initialement une approche conservatrice pour la prise en charge du plastron appendiculaire particulièrement dans notre contexte.

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Section: Introductionmentioning

confidence: 99%

Management of appendiceal mass

Garba

Ahmed

2008

Ann Afr Med

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“…In the case of interval appendicectomy, surgeons rely on their own experience or available reviews and studies. 13 The "classical" management of Appendiceal mass is conservative followed by interval appendicectomy, however many advocate immediate appendectomy, and a more modern approach is purely conservative that aims to avoid appendectomy. 14 So, we tried to assess our surgeon's experience in management of such condition in Saudi Arabia.…”

Section: Discussionmentioning

confidence: 99%

A survey of management of appendiceal mass among surgeons: what is best practice?

et al. 2017

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Background: An appendix mass is the result of a walled-off perforation of the appendix which localizes, resulting in a mass and it is encountered in up to 7% of patients presenting with acute appendicitis. The management of such problem is controversial. Immediate appendectomy may be technically demanding. Traditionally, management of these patients is conservative followed by interval appendectomy to prevent recurrence. However, the need for interval appendectomy has recently been questioned due to relatively small risk of recurrence. Also, there is still debate on adopting conservative management regarding the recurrence rate, the complication rate of interval appendectomy, and the potential for underlying malignancy. Our aim was to assess the preferred approach and current practice for management of acute appendix mass among surgeons in Al Taif Saudi Arabia.Methods: A questionnaire for the practice of surgeons in dealing with appendicular mass was designed and distributed to 21 consultants and 45 specialists.Results: 14.3% of consultant and 53.3% of specialist practiced the conservative management without routine interval appendectomy. Also, 14.3% and 26.7% of them respectively preferred immediate appendectomy while 71.4% of consultants and 20.0% of specialists did routine interval appendectomy. Most of the surgeons prefer to adopt the open method in immediate appendectomy while laparoscopic approach is the main adopting procedure for interval appendectomy. 57% of consultants stated risk of recurrence as the reason for performing interval appendectomy while, 53.4% of specialists would perform it to out-ruling neoplasm.Conclusions: Surgeons prefer to carry conservative approach with an interval appendectomy in management of appendix mass and laparoscopic approach for interval appendectomy. However immediate appendectomy and conservative management without interval appendectomy was preferred in other studies, which increase the necessity for national guidelines to be considered for management of this clinical condition.

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“…1,9,15,20,22 In case of existence or formation of appendiceal abscess, US or computed tomography-guided percutaneous drainage is indicated. 2,5,10,14,15 If the patient's condition is not improved, surgical intervention must be performed. According to our results, 9 patients out of 23 conservatively treated patients had experienced US or CT-guided percutaneous drainage.…”

Section: Discussionmentioning

confidence: 99%

Management of Appendiceal Mass and Abscess. An 11-Year Experience

Demetrashvili¹,

Kenchadze²,

Pipia³

et al. 2015

International Surgery

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The aim of our study is to compare the results of emergency surgery versus conservative treatment with interval surgery in patients diagnosed with appendiceal mass and abscess. A retrospective review of 48 patients with appendiceal mass and abscess treated from January 2002 to January 2013 at General Surgery Department of Kipshidze Central University Hospital was performed. Patients with emergency surgery were compared to patients treated by nonoperative management with interval surgery. Demographics, clinical profile, and operative outcomes were studied. The emergency surgery group included 25 patients, and the interval surgery group included 23 patients. The clinical characteristics of the emergency surgery and interval surgery groups were not statistically different. In the emergency surgery group, an open appendectomy was performed on 17 patients, and colonic resections (ileocecectomy or right hemicolectomy) were performed on 8 patients. In the interval surgery group, an open appendectomy was performed on 21 patients, and colonic resections were performed on 2 patients. There were no statistical differences in types of surgery, postoperative complications, operation time without colonic resections, and postoperative hospitalization period among these 2 groups. Operation time with colonic resections was of greater duration in the emergency surgery group than in the interval surgery group (P ¼ 0.04). Both treatment methods for appendiceal mass and abscess have the same results. The surgeon must consider clinical symptoms and results of investigations in each particular case when choosing an appropriate treatment method. Prospective randomized controlled trials are required for comparing the results of all 3 treatment methods of appendiceal mass.

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Interval Appendicectomy After Appendiceal Mass or Abscess in Adults: What is “Best Practice”?

Cited by 52 publications

References 10 publications

Management of appendiceal mass

Management of appendiceal mass

A survey of management of appendiceal mass among surgeons: what is best practice?

Management of Appendiceal Mass and Abscess. An 11-Year Experience

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