Our Summary

This research paper compares two methods of treating acute appendicitis (a sudden inflammation of the appendix): Endoscopic Retrograde Appendicitis Therapy (ERAT) and Laparoscopic Appendectomy. ERAT is a newer and less invasive method compared to the Laparoscopic Appendectomy, which involves removing the appendix through small incisions in the abdomen.

The study examined 422 patients with uncomplicated acute appendicitis from April 2017 to March 2020. They compared 79 patients treated with ERAT and 343 patients treated with Laparoscopic Appendectomy.

Results showed that the ERAT method had a 92.1% success rate within a year, and the patients reported less pain 6 hours after the treatment. The procedure time and hospital stay were also shorter for ERAT patients. The rate of recurrence within a year was 50 days for ERAT patients.

However, there was no significant difference in the rates of adverse events between the two groups. The Laparoscopic Appendectomy group had a 24.4% rate of adverse events, while the ERAT group had an 18.4% rate.

In conclusion, the study found that ERAT is a viable alternative to Laparoscopic Appendectomy for treating uncomplicated acute appendicitis. It was less painful, quicker, and required a shorter hospital stay. The risks associated with both methods were about the same.

FAQs

  1. What are the two methods of treating acute appendicitis discussed in the research paper?
  2. How does the ERAT method compare to the Laparoscopic Appendectomy in terms of success rate, pain, procedure time, and hospital stay?
  3. Was there any significant difference in the rates of adverse events between patients treated with ERAT and those treated with Laparoscopic Appendectomy?

Doctor’s Tip

A helpful tip a doctor might tell a patient about laparoscopic appendectomy is to follow post-operative instructions carefully, including taking pain medication as prescribed, avoiding heavy lifting and strenuous activity for a few weeks, and staying well hydrated. It is also important to watch for signs of infection, such as increased pain, redness, or drainage at the incision site, and to contact your doctor if you experience any concerning symptoms. Additionally, maintaining a healthy diet and staying active can help promote healing and prevent complications.

Suitable For

Patients with uncomplicated acute appendicitis are typically recommended for laparoscopic appendectomy. This study suggests that ERAT may also be a suitable option for these patients, as it showed similar success rates and lower pain levels compared to laparoscopic appendectomy. Patients who are looking for a less invasive treatment option or a quicker recovery time may benefit from considering ERAT as a potential treatment option for acute appendicitis. However, it is important for patients to consult with their healthcare provider to determine the best treatment plan for their individual situation.

Timeline

Before the laparoscopic appendectomy:

  1. Patient experiences sudden abdominal pain, usually starting in the middle of the abdomen and eventually moving to the lower right side.
  2. Patient may also experience nausea, vomiting, and loss of appetite.
  3. Patient visits a doctor or emergency room for evaluation.
  4. Diagnosis of acute appendicitis is made through physical examination, blood tests, and imaging tests such as ultrasound or CT scan.
  5. Patient is scheduled for a laparoscopic appendectomy procedure.

After the laparoscopic appendectomy:

  1. Patient undergoes the laparoscopic appendectomy procedure, which involves making small incisions in the abdomen and removing the inflamed appendix.
  2. Recovery time is shorter compared to traditional open surgery, with most patients able to go home the same day or within 24-48 hours.
  3. Patient may experience some pain and discomfort in the incision sites, which can be managed with pain medication.
  4. Patient is advised to rest and avoid strenuous activities for a few weeks.
  5. Follow-up appointments with the surgeon are scheduled to monitor the healing process and ensure there are no complications.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with a laparoscopic appendectomy?

  2. How does the recovery process differ between laparoscopic appendectomy and ERAT?

  3. Are there any long-term effects or implications of choosing one method over the other for treating acute appendicitis?

  4. How experienced are you in performing laparoscopic appendectomy and ERAT procedures?

  5. Are there any specific criteria or factors that would make me a better candidate for one method over the other?

  6. What is the success rate of each procedure in terms of preventing recurrence of appendicitis?

  7. How soon after the procedure can I expect to resume normal activities and work?

  8. Are there any dietary or lifestyle changes I should make following the procedure?

  9. How often do patients experience complications or adverse events following a laparoscopic appendectomy or ERAT?

  10. Will I need any follow-up appointments or tests after the procedure to monitor my recovery and overall health?

Reference

Authors: Yang B, Kong L, Ullah S, Zhao L, Liu D, Li D, Shi X, Jia X, Dalal P, Liu B. Journal: Endoscopy. 2022 Aug;54(8):747-754. doi: 10.1055/a-1737-6381. Epub 2022 Mar 7. PMID: 35021234