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  • Styrud, JKarolinska Institutet (author)

Appendectomy versus antibiotic treatment in acute appendicitis. A prospective multicenter randomized controlled trial

  • Article/chapterEnglish2006

Publisher, publication year, extent ...

  • 2006-04-27
  • Springer Science and Business Media LLC,2006
  • printrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:liu-37622
  • https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-37622URI
  • https://doi.org/10.1007/s00268-005-0304-6DOI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:1935469URI

Supplementary language notes

  • Language:English
  • Summary in:English

Part of subdatabase

Classification

  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  •   Background  Appendectomy has been the treatment for acute appendicitis for over 120 years. Antibiotic treatment has occasionally been used in small uncontrolled studies, instead of operation, but this alternative has never before been tried in a multicenter randomized trial. Patients and Methods  Male patients, 18–50 years of age, admitted to six different hospitals in Sweden between 1996 and 1999 were enrolled in the study. No women were enrolled by decision of the local ethics committee. If appendectomy was planned, patients were asked to participate, and those who agreed were randomized either to surgery or to antibiotic therapy. Patients randomized to surgery were operated on with open surgery or laparoscopically. Those randomized to antibiotic therapy were treated intravenously for 2 days, followed by oral treatment for 10 days. If symptoms did not resolve within 24 hours, an appendectomy was performed. Participants were monitored at the end of 1 week, 6 weeks, and 1 year. Results  During the study period 252 men participated, 124 in the surgery group and 128 in the antibiotic group. The frequency of appendicitis was 97% in the surgery group and 5% had a perforated appendix. The complication rate was 14% in the surgery group. In the antibiotic group 86% improved without surgery; 18 patients were operated on within 24 hours, and the diagnosis of acute appendicitis was confirmed in all but one patient, and he was suffering from terminal ileitis. There were seven patients (5%) with a perforated appendix in this group. The rate of recurrence of symptoms of appendicitis among the 111 patients treated with antibiotics was 14% during the 1-year follow-up. Conclusions  Acute nonperforated appendicitis can be treated successfully with antibiotics. However, there is a risk of recurrence in cases of acute appendicitis, and this risk should be compared with the risk of complications after appendectomy. 

Subject headings and genre

  • MEDICINE
  • MEDICIN

Added entries (persons, corporate bodies, meetings, titles ...)

  • Eriksson, SKarolinska Institutet (author)
  • Nilsson, IKarolinska Institutet (author)
  • Ahlberg, GKarolinska Institutet (author)
  • Haapaniemi, Staffan,1962-Östergötlands Läns Landsting,Linköpings universitet,Hälsouniversitetet,Avdelningen för kirurgi,Kirurgiska kliniken i Östergötland med verksamhet i Linköping, Norrköping och Motala (author)
  • Neovius, GKristianstad Central Hospital (author)
  • Rex, LBorås Hospital (author)
  • Badume, IKatrineholm Hospital (author)
  • Granström, LKarolinska Institutet (author)
  • Karolinska InstitutetHälsouniversitetet (creator_code:org_t)

Related titles

  • In:World Journal of Surgery: Springer Science and Business Media LLC30:6, s. 1033-10370364-23131432-2323

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