1
|
Zhang A, Zhang Y, Fan N, Hui Y, Zhou Y, Zeng L, Wang C, Shang L, Qi K, He X, Lin Y, Jiang X. Modified endoscopic retrograde appendicitis therapy vs. laparoscopic appendectomy for uncomplicated acute appendicitis in children. Dig Endosc 2024. [PMID: 38173187 DOI: 10.1111/den.14753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 12/27/2023] [Indexed: 01/05/2024]
Abstract
OBJECTIVES Modified endoscopic retrograde appendicitis therapy (mERAT) has been proposed as an alternative to laparoscopic appendectomy for the treatment of appendicitis. However, data from children in large samples are lacking. The aim of this article is to evaluate the efficacy between mERAT and laparoscopic appendectomy (LA) in children with uncomplicated appendicitis. METHOD We retrospectively analyzed 594 patients with suspected uncomplicated appendicitis from October 2018 to May 2021. A pool of 294 consecutive patients who met the inclusion criteria were ultimately enrolled in this study (228 and 66 patients in mERAT and LA, respectively). Given the differences in baseline clinical data (gender, age), the regression equation including differences in clinical baseline, grouping factor, and white blood cell count was established to address the influence of potential confounding factors. RESULT The initial success rate of mERAT management was 96.9%, and the recurrence rate was 6.9% in the mERAT group and 1.7% in the LA group within 1 year, which was no significant difference. But the mERAT group had a lower rate of adverse events. Finally, those results indicated that the treatment modalities, LA or mERAT, had no significant effect on initial success rate (P = 0.99) or recurrence rate (P = 0.17) within 1 year, but a significant effect on the adverse events rate during hospitalization (P = 0.01) in the multivariate regression analysis. CONCLUSION Among children with uncomplicated appendicitis, an initial mERAT management strategy had a success rate of 96.9%, which was similar to the LA group at 1 year. This follow-up supports the feasibility of mERAT alone as an alternative to surgery for uncomplicated appendicitis.
Collapse
Affiliation(s)
- Anding Zhang
- Department of Pediatrics, Tangdu Hospital, Fourth Military Medical University (Air Force Medical University), Xi'an, China
| | - Yalong Zhang
- Department of Pediatrics, Tangdu Hospital, Fourth Military Medical University (Air Force Medical University), Xi'an, China
| | - Na Fan
- Department of Pediatrics, Tangdu Hospital, Fourth Military Medical University (Air Force Medical University), Xi'an, China
| | - Yaxing Hui
- Department of Pediatrics, Tangdu Hospital, Fourth Military Medical University (Air Force Medical University), Xi'an, China
| | - Ying Zhou
- Department of Pediatrics, Tangdu Hospital, Fourth Military Medical University (Air Force Medical University), Xi'an, China
| | - Lingchao Zeng
- Department of Pediatrics, Tangdu Hospital, Fourth Military Medical University (Air Force Medical University), Xi'an, China
| | - Chunhui Wang
- Department of Pediatrics, Tangdu Hospital, Fourth Military Medical University (Air Force Medical University), Xi'an, China
| | - Lei Shang
- Department of Health Statistics, School of Preventive Medicine, Fourth Military Medical University (Air Force Medical University), Xi'an, China
| | - Ke Qi
- Department of Pediatrics, Tangdu Hospital, Fourth Military Medical University (Air Force Medical University), Xi'an, China
| | - Xiaobao He
- Department of Pediatrics, Tangdu Hospital, Fourth Military Medical University (Air Force Medical University), Xi'an, China
| | - Yan Lin
- Department of Pediatrics, Tangdu Hospital, Fourth Military Medical University (Air Force Medical University), Xi'an, China
| | - Xun Jiang
- Department of Pediatrics, Tangdu Hospital, Fourth Military Medical University (Air Force Medical University), Xi'an, China
| |
Collapse
|