A National Evaluation of the Conservative Management of Uncomplicated Acute Appendicitis: How Common Is This and What Are the Issues?

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  • Additional Information
    • Publication Year:
      2015
    • Author-Supplied Keywords:
      Health-related quality of life
      Laparoscopic surgery
      Surgical techniques
    • NAICS/Industry Codes:
      NAICS/Industry Codes 325410 Pharmaceutical and medicine manufacturing
      325411 Medicinal and Botanical Manufacturing
      414510 Pharmaceuticals and pharmacy supplies merchant wholesalers
      424210 Drugs and Druggists' Sundries Merchant Wholesalers
    • Abstract:
      Introduction: The management approach for acute appendicitis has been challenged in recent years, with numerous randomized controlled trials demonstrating that antibiotics/conservative management is an efficacious treatment, with lower complication rates. Methods: A national survey of all consultant general surgeons evaluating their practices was performed. Reasons for changed practices, choice of antibiotics and follow-up investigations were evaluated. In addition, the role of interval appendicectomy and conservative management in the pediatric population was also assessed. Results: The response rate for this survey was 74.7% (n = 74/99). Over one-fifth (n = 17, 22.9%) routinely treat acute appendicitis conservatively, while another 14.8% (n = 11) consider this approach in selected cases. Main reasons for modified practices included the presence of inflammatory phlegmon (75%), delayed presentation (64%), and recent evidence-based medicine developments (46%). Co-amoxiclav/clavulanic acid was the most popular antibiotic for conservative management (53%). Alternatively, combinations of antibiotics were also utilized. One-third felt interval appendicectomy was warranted, while one-fifth supported conservative management in the paediatric setting. The overwhelming majority (>95%) advocate follow-up colonoscopy ± computed tomography in any patient aged >40 years managed conservatively. Conclusion: Considerable variation in management of uncomplicated appendicitis remains in Ireland despite growing evidence suggesting that the non-operative approach is safe. Reasons for adopting a conservative management practice have been identified and reflect the expanding literature on this subject. © 2015 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]
    • Abstract:
      Copyright of Digestive Surgery is the property of Karger AG and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
    • ISSN:
      02534886
    • Accession Number:
      109362509
  • Citations
    • ABNT:
      KELLY, M. E. et al. A National Evaluation of the Conservative Management of Uncomplicated Acute Appendicitis: How Common Is This and What Are the Issues? Digestive Surgery, [s. l.], v. 32, n. 5, p. 325, 2015. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=edb&AN=109362509&custid=s6224580. Acesso em: 29 maio. 2020.
    • AMA:
      Kelly ME, Khan asif, ur Rehman J, et al. A National Evaluation of the Conservative Management of Uncomplicated Acute Appendicitis: How Common Is This and What Are the Issues? Digestive Surgery. 2015;32(5):325. http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=edb&AN=109362509&custid=s6224580. Accessed May 29, 2020.
    • APA:
      Kelly, M. E., Khan, asif, ur Rehman, J., Waldron, R. M., Khan, W., Barry, K., & Khan, I. Z. (2015). A National Evaluation of the Conservative Management of Uncomplicated Acute Appendicitis: How Common Is This and What Are the Issues? Digestive Surgery, 32(5), 325.
    • Chicago/Turabian: Author-Date:
      Kelly, Michael E., asif Khan, Jameel ur Rehman, Ronan M. Waldron, Waqar Khan, Kevin Barry, and Iqbal Z. Khan. 2015. “A National Evaluation of the Conservative Management of Uncomplicated Acute Appendicitis: How Common Is This and What Are the Issues?” Digestive Surgery 32 (5): 325. http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=edb&AN=109362509&custid=s6224580.
    • Harvard:
      Kelly, M. E. et al. (2015) ‘A National Evaluation of the Conservative Management of Uncomplicated Acute Appendicitis: How Common Is This and What Are the Issues?’, Digestive Surgery, 32(5), p. 325. Available at: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=edb&AN=109362509&custid=s6224580 (Accessed: 29 May 2020).
    • Harvard: Australian:
      Kelly, ME, Khan, asif, ur Rehman, J, Waldron, RM, Khan, W, Barry, K & Khan, IZ 2015, ‘A National Evaluation of the Conservative Management of Uncomplicated Acute Appendicitis: How Common Is This and What Are the Issues?’, Digestive Surgery, vol. 32, no. 5, p. 325, viewed 29 May 2020, .
    • MLA:
      Kelly, Michael E., et al. “A National Evaluation of the Conservative Management of Uncomplicated Acute Appendicitis: How Common Is This and What Are the Issues?” Digestive Surgery, vol. 32, no. 5, Sept. 2015, p. 325. EBSCOhost, search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=edb&AN=109362509&custid=s6224580.
    • Chicago/Turabian: Humanities:
      Kelly, Michael E., asif Khan, Jameel ur Rehman, Ronan M. Waldron, Waqar Khan, Kevin Barry, and Iqbal Z. Khan. “A National Evaluation of the Conservative Management of Uncomplicated Acute Appendicitis: How Common Is This and What Are the Issues?” Digestive Surgery 32, no. 5 (September 2015): 325. http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=edb&AN=109362509&custid=s6224580.
    • Vancouver/ICMJE:
      Kelly ME, Khan asif, ur Rehman J, Waldron RM, Khan W, Barry K, et al. A National Evaluation of the Conservative Management of Uncomplicated Acute Appendicitis: How Common Is This and What Are the Issues? Digestive Surgery [Internet]. 2015 Sep [cited 2020 May 29];32(5):325. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=edb&AN=109362509&custid=s6224580