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Category: Volume 08 Issue 05 May 2020
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Title: Antibiotics versus a emergency open appendectomy conservative management- A primary treatment of uncomplicated acute appendicitis: A randomized controlled trial

Authors: Dr Chauhan A, Datt C.K., Dr Chandel H, Sharma Sharad

 DOI: https://dx.doi.org/10.18535/jmscr/v8i5.64

Abstract

 

Background: Although appendectomy is the gold standard treatment of acute appenditicitis. The main motive of this randomized controlled study is to determines the role of antibiotics in management of uncomplicated acute appendicitis and to ensure that appendectomy is still gold standard or not.

Method: After randomization between 100 consecutive suspected acute appendicitis, patients were screened by clinical examination and modified alvarado score. All randomly selected patients were allocated equally in conservative or antibiotic (AG) and surgical group (SG). Follow up was done till 6 months.

Result: In this randomized study 90% patients have responded to conservative management. 6% patients have treatment failure and undergone emergency appendectomy in primary hospital stay. 4% patients in subsequent follow up period of 6 months developed recurrent appendicitis and were operated at some other institute. Hence, the recurrence rate in conservative group is 4%. The success rate of appendectomy group is 100% by definition, but surgery related complications, wound related complication and prolonged hospital stay is much higher in comparative to conservative group.

Conclusion: By our study we can infer that conservative management had many advantage like high success rate, lower recurrence rate and shorter hospitalization stay with reduced mortality and morbidity, hence should be offered to young patients of uncomplicated acute appendicitis as a first line treatment by choice.

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Corresponding Author

Dr Sharma Sharad

PG Student, Department of Surgery, Gajra Raja Medical College, Gwalior