Laparoscopic Surgery for uncomplicated appendicitis effective and safe in adults

Laparoscopic Surgery for uncomplicated appendicitis effective and safe in adults. Appendectomy is considered the gold standard treatment for acute appendicitis.

Researchers found that more than 97 per cent of the surgeries for appendicitis were laparoscopic, or minimally invasive, and most patients were discharged the same day or the next day. Only 3 per cent of the procedures resulted in complications. Rates of unnecessary surgery -- removing a "normal" appendix -- were low (less than 4 per cent) but were much higher in people without imaging studies before their operation (nearly 20 per cent). Finally, 1 per cent of patients overall had underlying tumours in their appendix; in people ages 65 and older, it was nearly 3 per cent.

Acute appendicitis is the most common surgical emergency in children. The lifetime risk of developing appendicitis is 7%–8%, with a peak incidence in the teenage years. One out of every 2,000 people has an appendectomy sometime during their lifetime. Treatment requires an operation to remove the infected appendix. Traditionally, the appendix is removed through an incision in the right lower abdominal wall.

In most laparoscopic appendectomies, surgeons operate through 3 small incisions (each ¼ to ½ inch) while watching an enlarged image of the patient’s internal organs on a television monitor. In some cases, one of the small openings may be lengthened to complete the procedure.

There has been a growing debate over the past several years about whether uncomplicated appendicitis should be treated with antibiotics rather than surgery. A number of studies, many performed internationally, have argued that antibiotic treatment is safe and may be better than surgery. However, those studies did not reflect the current surgical practice and outcomes in the United States.

The researchers used data from the 2016 American College of Surgeons' adult National Surgical Quality Improvement Program to analyze 7,778 appendectomies that were performed at 115 U.S. hospitals.

This study demonstrates that surgery for uncomplicated appendicitis is very safe. As people contemplate their choices for managing appendicitis -- antibiotics or surgery -- these data can help ensure they make a fully informed choice.