Treatment of acute appendicitis: Urgent surgery or emergent surgery?

Background: The standard treatment of acute appendicitis, which is a rapidly progressive inflammatory disease, remains surgery. However, several studies have suggested antibiotics treatment for acute appendicitis, especially in centers where surgery at all hours is not possible. Therefore, in this study, we investigated the relationship between the preoperative waiting period and postoperative complications in patients who underwent interval surgery following conservative management during the same admission.

Methods: All patients who were diagnosed with uncomplicated acute appendicitis between October 2014 and February 2015 and underwent surgery at a single center were included in this retrospective study. Patients were divided into two groups based on the waiting period between the diagnosis and the time of surgery: group A (emergency, waiting period <10 h) and group B (urgency, waiting period ≥10 h). The demographic features, preoperative waiting period, antibiotics use, pathological diagnosis, postoperative complications, length of hospital stay, and readmission were compared between the two groups.

Results: This study comprised 160 patients, including 79 and 81 patients in groups A and B, respectively. The demographic features, comorbidities, and pathological diagnosis were comparable between the two groups. The average preoperative waiting period was significantly longer in group B than in group A. However, the mean length of hospital stay and the rate of postoperative complications, including infections at the surgical sites and intra-abdominal abscesses, were similar between the two groups.

Conclusion: Our analyses revealed that there were no disadvantages associated with a longer preoperative waiting period in patients diagnosed with uncomplicated appendicitis.