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Abstract

Aims

Interval appendicectomy occurs at a rate of < 15 %. It is recommended in non operative appendicitis (complicated appendicitis, appendix mass) to reduce recurrence. Acute appendicectomy rate was reduced in Covid 19 pandemic era, as aerosol generating procedures were deemed high risk. Interval appendicectomy can be offered after 6 weeks dependent on pre-requisite interval colorectal screening (colonoscopy or CT scan) prior to surgery. Aim of study is to assess the interval appendectomy at a single centre.

Methods

Cohort study carried out from Mar'2020 to Dec'2023. Descriptive demography & post-operative outcomes were evaluated for interval appendicectomy, and acute appendicectomy were used as controls.

Results

Interval appendicectomy (n = 45)Appendicectomy (n = 515)Mann Whitney U (p test)
Age(yrs)47.935.8< 0.0001
Sex(M:F)19 : 26251 : 264NS
ASA(median)21NS
BMI26.525.5NS
WCC(x109/L)6.513.2< 0.0001
CRP(mg/L)3.466.3< 0.0001
Laparoscopic45507
Op time(mins)74.474.9NS
Appendix length(mm)55.766.6< 0.0001
Appendix diameter(mm)9.911.2NS
LOS(days)02< 0.0001
AB use(days)
In-patient0 ± 0.52 ± 1< 0.0001
Post-op0 ± 00 ± 2.5
Cost(£)10464269< 0.0005
Interval appendicectomy (n = 45)Appendicectomy (n = 515)Mann Whitney U (p test)
Age(yrs)47.935.8< 0.0001
Sex(M:F)19 : 26251 : 264NS
ASA(median)21NS
BMI26.525.5NS
WCC(x109/L)6.513.2< 0.0001
CRP(mg/L)3.466.3< 0.0001
Laparoscopic45507
Op time(mins)74.474.9NS
Appendix length(mm)55.766.6< 0.0001
Appendix diameter(mm)9.911.2NS
LOS(days)02< 0.0001
AB use(days)
In-patient0 ± 0.52 ± 1< 0.0001
Post-op0 ± 00 ± 2.5
Cost(£)10464269< 0.0005
Interval appendicectomy (n = 45)Appendicectomy (n = 515)Mann Whitney U (p test)
Age(yrs)47.935.8< 0.0001
Sex(M:F)19 : 26251 : 264NS
ASA(median)21NS
BMI26.525.5NS
WCC(x109/L)6.513.2< 0.0001
CRP(mg/L)3.466.3< 0.0001
Laparoscopic45507
Op time(mins)74.474.9NS
Appendix length(mm)55.766.6< 0.0001
Appendix diameter(mm)9.911.2NS
LOS(days)02< 0.0001
AB use(days)
In-patient0 ± 0.52 ± 1< 0.0001
Post-op0 ± 00 ± 2.5
Cost(£)10464269< 0.0005
Interval appendicectomy (n = 45)Appendicectomy (n = 515)Mann Whitney U (p test)
Age(yrs)47.935.8< 0.0001
Sex(M:F)19 : 26251 : 264NS
ASA(median)21NS
BMI26.525.5NS
WCC(x109/L)6.513.2< 0.0001
CRP(mg/L)3.466.3< 0.0001
Laparoscopic45507
Op time(mins)74.474.9NS
Appendix length(mm)55.766.6< 0.0001
Appendix diameter(mm)9.911.2NS
LOS(days)02< 0.0001
AB use(days)
In-patient0 ± 0.52 ± 1< 0.0001
Post-op0 ± 00 ± 2.5
Cost(£)10464269< 0.0005

Conclusion

Interval appendicectomy is a safe and cost effective option in the management of appendix mass. Interval appendectomy allows resolution of acute appendicitis resulting in fewer intraoperative & postoperative complications. It reduces the chance of bowel resection & can be done as a day case procedure. However interval appendicectomy my require work-up prior to surgery.

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