Treatment of appendiceal mass: prospective, randomized clinical trial.
BACKGROUND
Appendiceal mass may be treated in several ways. However, no randomized trial has been conducted to find the best option.


OBJECTIVE
To compare the three most commonly used methods for treating appendiceal mass.


METHODS
Over a three-year period, 60 consecutive patients with appendiceal mass were randomly allocated to three groups: Group A--initial conservative treatment followed by interval appendectomy six weeks later; Group B--appendectomy as soon as appendiceal mass resolved using conservative means; Group C--conservative treatment alone. Short-term outcome measures included operative time, operative difficulty, postoperative complications, length of hospital stay, and duration of time away from work. Long-term outcome measures were: number of hospital visits made, presence of severe incisional pain, scar appearance, and patients with recurrent appendicitis.


RESULTS
Baseline characteristics were comparable in the three groups. In patients in Group A, operative time was less, adhesions were encountered less frequently, the incision had to be extended less often and post-operative complications were fewer, as compared to Group B. Patients in Group C had the shortest hospital stay and duration of work-days lost; only 2 of 20 patients in this group developed recurrent appendicitis during a follow-up period of 24-52 (median 33.5) months.


CONCLUSIONS
Of the three treatment modalities compared, conservative treatment without subsequent appendectomy appears to be the best.
Kumar
Sunil
S
Department of Surgery, Guru Teg Bahadur Hospital and University College of Medical Sciences, Delhi-110 095, India. drskg_15@sify.com
Jain
Sundeep
S
D015746:Abdominal Pain / Q000175:diagnosis / Q000209:etiology; D000704:Analysis of Variance; D000900:Anti-Bacterial Agents; D001062:Appendectomy / Q000009:adverse effects / Q000379:methods*; D001064:Appendicitis / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery*; D001065:Appendix / Q000473:pathology*; D016009:Chi-Square Distribution; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011183:Postoperative Complications; D011446:Prospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014421:Turkey
D000900:Anti-Bacterial Agents