Abstract
In cases of acute appendicitis, we have mostly performed emergency laparoscopic appendectomy (EA). However, for some cases of acute appendicitis with an appendiceal mass which satisfy our criteria, we have performed interval laparoscopic appendectomy (IA) one to three months after nonoperative treatment with antibiotics. The indications for IA in our institution are as follows: 1) Abdominal CT shows an appendiceal mass; 2) Abdominal examination does not reveal panperitonitis; and 3) The condition responds to nonoperative treatment in the first 48 hours. In this study, we aimed to elucidate the significance of IA. We examined 21 cases in which abdominal CT showed an appendiceal mass (7 cases in EA and 14 cases in IA). In this study, the operation time, volume of bleeding, and ratio of conversion to laparotomy were significantly better in IA than EA. We could perform an easier and safer operation in IA than EA. Moreover, more than half of the surgical specimens of IA showed inflammatory change even after successful conservative treatment. We should consider IA because of the risk of recurrence. From the aspect of health insurance, there were no differences between EA and IA. We conclude that IA is effective for acute appendicitis with an appendiceal mass.
