Comparison between an Interval Appendectomy and an Urgent Appendectomy for Patients of Periappendiceal Abscess

Cho, Sung Wook; Kim, In Gyu; Lee, Bong Hwa

Abstract

PURPOSE: Our goal was to compare the clinical course after an interval appendectomy with that after an urgent appendectomy in patients with localized periappendiceal abscesses confirmed by radiology.
METHODS
This study was a retrospective review of 57 consecutive patients who were treated between February 1999 and June 2003 for appendicitis complicated by periappendiceal abscess. For periappendiceal abscesses, 37 patients were treated with an urgent appendectomy, but 20 patients were treated initially non-operatively. Finally, 12 of those 20 patients underwent an interval appendectomy. Exclusion criteria were periappendiceal abscesses spreading to the whole abdomen diffusely, as confirmed by either abdominal CT or ultrasonography.
RESULTS
Interval appendectomies were performed in 12 (60%) of the patients in the 20 initial non-operative group. The complication rate for the 12 patients in the initial non-operative group who underwent an interval appendectomy was significantly lower than that for the 37 patients in the urgent appendectomy group (P<0.05). The duration of nothing by mouth (NPO) and the length of the hospital stay in the initial non-operative group with an interval appendectomy were also significantly lower than those in the urgent appendectomy group (P<0.05). The histopathologic finding for the interval appendectomy group was suppurative appendicitis in 9 of the 12 cases.
CONCLUSIONS
Initial non-operative treatment with an interval appendectomy has been relatively fewer postoperative problems than an urgent appendectomy in patients with localized periappendiceal abscesses in our study, and further study in more large series considered to be needed.