Scientists Say You Might Not Need Surgery for Appendicitis In Future
Appendectomy is one of the most common surgeries in the United States, and the only effective treatment for appendicitis until recently. However, new research suggests that less invasive surgery-free options may be a better option for people with mild cases of appendicitis.
Appendectomy, or removing the appendix, is currently the preferred treatment for appendicitis. This procedure has one key benefit: it completely resolves the issue by removing the inflamed tissue permanently. However, there are also drawbacks. Surgery can have complications, even the laparoscopic options currently favored. In addition, scar tissue from the surgery can build up and require future surgeries. Appendectomies and follow-up care are far more expensive than a round of antibiotics. Last, appendectomies require hospitalization and time off from work and other duties.
Research from Finland published this month in the Journal of the American Medical Association suggests that using antibiotics for uncomplicated appendicitis–that is, appendicitis with no rupture and no signs of complications–may respond just as well to antibiotics. Uncomplicated appendicitis comprises 80% of all appendicitis cases. In this study, half of 500 adults with appendicitis received an appendectomy while others were placed on antibiotics. almost three-quarters of the patients who were treated with antibiotics recovered completely and had no recurrence for at least a year. The remaining quarter received an appendectomy when antibiotics did not resolve the appendicitis and had no more complications that patients who had been given surgical intervention immediately.
While this study is promising, there are a few drawbacks to an antibiotic approach to appendicitis. First, about one quarter of patients needed surgery eventually so the antibiotics were an unnecessary treatment for this group. It is believed that these cases may have been caused by an obstruction rather than an infection, and thus antibiotics did not address the cause of the appendicitis. Another drawback of antibiotic therapy is that the use of antibiotics contributes to antibiotic resistance.
Future studies on this topic are planned. Researchers would like to examine how children, who are the majority of appendicitis cases, respond to antibiotic therapy. In addition, researchers may explore which antibiotics are most effective and what minimum dose is best for treating appendicitis without contributing heavily to antibiotic resistance.
Change in medical protocols happens slowly due to a high level of evidence needed to challenge current accepted practice. While the current surgical approach to appendicitis will remain the gold standard until further research has been performed, this new study offers hope for a less invasive and more cost-effective approach to this common medical crisis.