The Role of Interval Appendicectomy Following Conservative Management of Appendicular Mass and Appendicular Abscess: A Prospective Observational Study from a Tertiary Care Centre in Odisha, India

Sourav Paikray; Ashoak Acharya; Dr. Asutosh Dhal; Durga Prasad Sahu

doi:10.51168/byncv587

Autori

Sourav Paikray Postgraduate Resident, Department of General Surgery, Hi-Tech Medical College and Hospital, Bhubaneswar, Odisha, India
Ashoak Acharya Associate Professor, Department of General Surgery, Hi-Tech Medical College and Hospital, Bhubaneswar, Odisha, India
Dr. Asutosh Dhal Department of General Surgery, Hi-Tech Medical College and Hospital, Bhubaneswar, Odisha 751025, India.
Durga Prasad Sahu Postgraduate Resident, Department of General Surgery, Hi-Tech Medical College and Hospital, Bhubaneswar, Odisha, India

DOI:

https://doi.org/10.51168/byncv587

Cuvinte cheie:

acute appendicitis, appendicular mass, appendicular abscess, conservative management, interval appendicectomy, laparoscopic appendicectomy

Rezumat

Background

Conservative management using the Ochsner–Sherren regimen is widely accepted for appendicular mass and appendicular abscess. However, the routine role of interval appendicectomy after successful non-operative treatment remains controversial because of concerns regarding recurrence, operative morbidity, and occult appendiceal neoplasia.

Objective

To evaluate the clinical outcomes of conservative management and determine the role of interval appendicectomy in adults presenting with appendicular mass or appendicular abscess at a tertiary care teaching hospital.

Methods

A hospital-based prospective observational cohort study was conducted among 50 consecutive adult patients with clinically and radiologically confirmed appendicular mass or appendicular abscess who were managed initially with conservative treatment. Patients with abscesses underwent drainage when clinically indicated. Following successful resolution, participants were reassessed after 6–12 weeks and either underwent interval appendicectomy or continued active observation according to clinical judgement and patient preference.

Results

Conservative management was successful in all 50 participants. Twenty-eight (56.0%) had appendicular mass and 22 (44.0%) had appendicular abscess. Forty-two patients (84.0%) underwent interval appendicectomy, while eight (16.0%) remained under observation. Laparoscopic appendicectomy was successfully completed in 33 patients (78.6%), whereas seven (16.6%) required conversion to open surgery because of dense adhesions. Histopathological examination demonstrated findings consistent with resolved appendicitis.

Conclusion

Initial conservative management was safe and effective in this cohort. Interval appendicectomy was associated with low morbidity and favourable surgical outcomes. However, the short follow-up period and limited sample size support an individualized rather than routine approach to interval appendicectomy, particularly in younger patients.

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