An appendectomy (American English) or appendicectomy (British English) is a surgical operation in which the vermiform appendix (a portion of the intestine) is removed. Appendectomy is normally performed as an urgent or emergency procedure to treat complicated acute appendicitis.[1]
Appendectomy may be performed laparoscopically (as minimally invasive surgery) or as an open operation.[2] Over the 2010s, surgical practice has increasingly moved towards routinely offering laparoscopic appendicectomy; for example in the United Kingdom over 95% of adult appendicectomies are planned as laparoscopic procedures.[3] Laparoscopy is often used if the diagnosis is in doubt, or in order to leave a less visible surgical scar. Recovery may be slightly faster after laparoscopic surgery, although the laparoscopic procedure itself is more expensive and resource-intensive than open surgery and generally takes longer. Advanced pelvic sepsis occasionally requires a lower midline laparotomy.
Complicated (perforated) appendicitis should undergo prompt surgical intervention.[1] There has been significant recent trial evidence that uncomplicated appendicitis can be treated with either antibiotics or appendicectomy.[4][5] After appendicectomy the main difference in treatment is the length of time the antibiotics are administered. For uncomplicated appendicitis, antibiotics should be continued up to 24 hours post-operatively. For complicated appendicitis, antibiotics should be continued for anywhere between 3 and 7 days.[1] An interval appendectomy is generally performed 6–8 weeks after conservative management with antibiotics for special cases, such as perforated appendicitis.[6] Delay of appendectomy 24 hours after admission for symptoms of appendicitis has not shown to increase risk of perforation or other complications.[7]
^ abcBackbourne, Lorne. Surgical Recall. Wolters Kluwer. pp. 198–203.
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^RIFT Study Group on behalf of the West Midlands Research Collaborative (3 December 2019). "Evaluation of appendicitis risk prediction models in adults with suspected appendicitis". British Journal of Surgery. 107 (1): 73–86. doi:10.1002/bjs.11440. ISSN 1365-2168. PMC 6972511. PMID 31797357.
^Javanmard-Emamghissi, Hannah (Sep 3, 2021). "Antibiotics as first-line alternative to appendicectomy in adult appendicitis: 90-day follow-up from a prospective, multicentre cohort study". The British Journal of Surgery. 108 (11): 1351–1359. doi:10.1093/bjs/znab287. PMC 8499866. PMID 34476484. Archived from the original on 8 September 2021. Retrieved 8 September 2021.
^CODA Collaborative (Oct 5, 2020). "A Randomized Trial Comparing Antibiotics with Appendectomy for Appendicitis". The New England Journal of Medicine. 20 (383): 1907–1919. doi:10.1056/NEJMoa2014320. PMID 33017106. S2CID 222151141.
^[1] Archived 2020-10-13 at the Wayback Machine, Sell N, O'Donnell T, Saillant N. Laparoscopic Appendectomy and Open Umbilical Hernia Repair. J Med Ins. 2019;2019(270) doi:https://jomi.com/article/270 Archived 2022-06-18 at the Wayback Machine
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An appendectomy (American English) or appendicectomy (British English) is a surgical operation in which the vermiform appendix (a portion of the intestine)...
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