Patients With Appendicitis May Not Need Surgery, New Research Shows
NEW YORK (CBSNewYork) -- The most common emergency surgical procedure in the U.S. is an appendectomy - removal of the appendix.
But now there's mounting evidence that some patients can avoid or delay that operation and receive treatment with antibiotics instead, CBS2's Dr. Max Gomez reported Monday.
Five years ago, Heather VanDusen ended up in the emergency room at the University of Washington Medical Center.
"Really terrible pain, more pain than I had ever really felt with stomach issues before," VanDusen said.
The diagnosis: appendicitis, which typically meant urgent surgery to remove the infected or inflamed appendix. But now the latest research has led the American College of Surgeons to say antibiotics can be a first-line treatment for many patients.
"If you have appendicitis and present to the emergency department, you have treatment options from surgery or antibiotics," said Dr. Giana Davidson, associate professor of surgery at the University of Washington.
Dr. Davidson is a co-author on the largest ever randomized clinical trial on appendicitis treatment. 1,500 patients received either an appendectomy or antibiotics.
In the first three months, nearly seven in 10 patients in the antibiotic group avoided surgery. Four years out, just under half of patients in the antibiotic group had surgery.
Researchers have created an online tool to help patients and surgeons discuss the pros and cons of each approach based on the current data.
"We're hoping that helps empower people to have discussions with their surgeons about the treatment option that makes the most sense for them at that moment," said Dr. Davison.
VanDusen chose antibiotics over an appendectomy.
"They didn't make me feel the greatest. I was really tired," she said. "But after I finished the course of antibiotics... life went back to normal. I have not had another episode."
Appendicitis surgery these days is much less invasive that it used to be. It can often be done laparoscopically and sometimes even on an outpatient basis. However, if the appendix has burst, you will likely need an open operation and a longer stay in the hospital.
The clinical trial did not include children, but researchers say other studies are looking at whether antibiotics could work for pediatric patients.
