Although surgical removal of
the appendix has long been a standard treatment, a new study found that
almost three-quarters of people treated withantibiotics could be spared
the invasive procedure known asappendectomy.
“For more than a century, appendectomy
has been the standard treatment,” said the study’s lead author Dr.
Paulina Salminen, of Turku University Hospital in Finland.
But about 80 percent of patients with an
inflamed appendix, commonly called appendicitis, don’t need to have
their appendix surgically removed, and those who ultimately do need the
surgery aren’t hurt by waiting, according to Salminen.
She thinks that this and other studies
will change how appendicitis is treated. “Now we know that only a small
proportion of appendicitis patients need an emergency operation,”
Salminen said.
However, there are two types of
appendicitis — one that always requires surgery and a milder form that
can be treated with antibiotics, Salminen explained. “The majority of
appendicitis is the milder form, making up almost 80 percent of the
cases of appendicitis,” she said.
The more serious type of appendicitis can
cause the appendix to rupture. Treating this type of appendicitis
requires that the appendix be removed, she said.
A CT scan can accurately detect which type of appendicitis someone has, Salminen added.
The study’s findings were published June 16 in the Journal of the American Medical Association.
For the study, Salminen and colleagues
randomly assigned 530 patients with acute appendicitis to appendectomy
or a 10-day course of antibiotics.
The researchers found that appendectomies
were 99.6 percent successful. Among patients treated with antibiotics
and followed for a year, 73 percent did not need surgery. However, 27
percent of the patients treated with antibiotics had to have their
appendix removed within a year after treatment.
But there were no major complications associated with delaying surgery, the researchers said.
Dr. Edward Livingston, deputy editor of JAMA and
coauthor of an accompanying editorial, said, “It’s kind of lost to
history why people started doing appendectomies, but it has become so
routine that when someone comes in with appendicitis they get whisked
into the operating room.”
By Steven Reinberg
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