Abstract
Purpose : The present study was made to elucidate the risk factors associated with recurrence after conservative therapy for acute appendicitis and to investigate the applicability of interval appendectomy. Methods : A follow-up survey was conducted in consecutive 114 patients with acute appendicitis treated with conservative therapy in our hospital between 2008 and 2013. The patients were divided into a recurrent group and a non-recurrent group and were comparatively investigated. Results : Of the 112 patients who could be followed up, two patients (2%) underwent interval appendectomy. Of the remaining 110 patients, recurrence was observed in 34 patients (30%, recurrent group) and not observed in 76 patients (68%, non-recurrent group). Surgery was eventually required in 27 patients (24%). Our investigation of the appendix diameter before the initial conservative therapy indicated that diameters of 10 mm or larger were significantly more common in the recurrent group (62%) than in the non-recurrent group (35%) (P=0.003). Of 27 patients who eventually required surgery, 11 patients underwent interval appendectomy, all of whom received laparoscopic surgery. None of these 11 patients underwent conversion (open) surgery or experienced postoperative complications. Conclusion : The high recurrence rate after conservative therapy among patients with the enlarged appendix of 10 mm or more in diameter indicates that interval appendectomy should be considered for such patients.
