2016 Volume 36 Issue 6 Pages 1013-1019
The concept of interval appendectomy (IA) has become popular as an elective surgical strategy for acute appendicitis, because it is less invasive, is associated with fewer postoperative complications, and is cosmetically advantageous. Although IA is performed after the inflammation has subsided with conservative initial treatment in the acute stage, it is still under debate as to which approach, emergent or interval appendectomy, is the better treatment strategy for patients with acute appendicitis. The aim of this study was to conduct a retrospective comparison of the clinical data of patients who had undergone laparoscopic IA (LIA, n=37) and those who had undergone laparoscopic emergency appendectomy (LEA, n=13), and to establish a new scoring system IA scoring system to predict the potential success of LIA. The WBC count and serum CRP were significantly lower in the LIA group (P=0.004 and 0.020), whereas the pelvic abscess cavity size, intestinal ectasia and ascites were significantly more severe in the LEA group (P=0.007, 0.023 and 0.022). Logistic regression analysis was performed using the above five factors, and a scoring system to predict the potential success of LIA was established using each regression coefficient with approximate proportion (WBC count: 0 or 2 points; serum CRP and intestinal ectasia: 0-1 point; abscess cavity: 0-2 points; and ascites: 0-3 points). An IA score of ≤4 was associated with a 91.9% of sensitivity, 90.9% of specificity and 91.7% of accuracy for potentially successful LIA.
