Perforated appendicitis: urgency or interval surgery?
BACKGROUND
The purpose of this study was to report how conservative treatment with interval appendectomy (IA) of ruptured appendicitis with localized abscess or phlegmon affects the outcome of patients.


METHODS
From January 2001 to December 2005, 121 patients with ruptured appendicitis with localized abscess or phlegmon were treated in our hospital. 104 patients underwent appendectomy (Group A); 17 patients underwent antibiotic treatment with interval appendectomy (Group B). The clinical characteristics (age and sex), laboratory data, mean time to surgery, operative time, complications, hospital days and cost of hospitalization were recorded.


RESULTS
The sex, age, white blood cell count (WBC), body temperature, operation time, length of stay after surgery, first flatus, oral feeding, passage of stools, cost and overall complications (including wound infection, wound disruption, intra-abdominal abscess and enterocutaneous fistula) were not significantly different between the two groups. However, the length of stay after diagnosis established of group B was significantly longer in group B than in group A.


CONCLUSIONS
Conservative treatment with IA is a safe and effective method to treat perforated appendicitis with localized abscess and phlegmon, but the recovery time may be longer and also the hospital stay (since diagnosis established). Thus this method is not cost-saving.
D018784:Abdominal Abscess / Q000175:diagnosis / Q000191:economics / Q000601:surgery; D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000191:economics; D001062:Appendectomy / Q000191:economics / Q000379:methods*; D001064:Appendicitis / Q000175:diagnosis / Q000191:economics / Q000601:surgery*; D002481:Cellulitis / Q000175:diagnosis / Q000191:economics / Q000601:surgery; D003362:Cost-Benefit Analysis; D004630:Emergencies / Q000191:economics; D005260:Female; D017721:Hospital Costs / Q000706:statistics & numerical data; D006801:Humans; D010535:Laparoscopy / Q000191:economics / Q000379:methods; D007902:Length of Stay / Q000191:economics; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D010359:Patient Readmission / Q000191:economics; D010538:Peritonitis / Q000175:diagnosis / Q000191:economics / Q000601:surgery; D011183:Postoperative Complications / Q000175:diagnosis / Q000191:economics / Q000209:etiology; D011300:Preoperative Care / Q000191:economics; D012189:Retrospective Studies; D013624:Taiwan
D000900:Anti-Bacterial Agents