- An appendectomy is one of the most common procedures performed by the NHS.
- Researchers say the only risk of not operating is recurrent appendicitis later
Operations to remove the appendix could soon become a thing of the past.
Swedish experts say appendicitis, when the mysterious worm-like organ becomes infected, can be effectively treated with antibiotics.
It could spell the end of appendectomy, one of the most common procedures performed by the NHS.
Prompt removal of the appendix has been the standard treatment for more than a century.
But the Karolinska Institutet researchers argue that the only risk of not operating and relying on antibiotics is another bout of appendicitis.
Swedish experts say the only risk of not operating and relying on drugs is a recurrence of appendicitis. Their analysis of the evidence found that less than half of the patients treated with antibiotics fell again.
The researchers, from the Karolinska Institutet in Stockholm, used data from two randomized controlled trials in the Swedish National Patient Registry. Pictured: Stock image highlighting the location of an inflamed appendix
The findings come amid a subtle push to reduce NHS hospitalization costs and the number of procedures carried out by the health service.
Writing in the journal JAMA Surgery, the team said: “The current data will be even more beneficial to clinicians and patients when making a treatment decision.”
The experts analyzed two separate trials, which evaluated the outcomes of 292 hospitalized patients with appendicitis.
The condition, which causes stomach pain that spreads to the lower right side, can be life-threatening without prompt treatment.
Forty patients were divided into two groups as part of the first study. Half received an appendectomy.
WHAT IS APPENDICITIS?
Appendicitis is an inflammation of the appendix, a two to four inch long organ connected to the large intestine.
Appendicitis can cause severe pain and it is important to treat it quickly in case the appendix ruptures, which can cause a life-threatening illness.
In most cases, surgeons will remove the appendix in an appendectomy; Scientists aren’t sure why people need an appendix, but removing it doesn’t harm people.
The causes of appendicitis are not clear, but it is believed to be caused by something blocking the entrance to the organ.
Symptoms include pain in the stomach that then moves to the lower right side and becomes severe.
Pressing on this area, coughing, or walking can make the pain worse, and other symptoms may include nausea, vomiting, loss of appetite, diarrhea, and fever.
The others received antibiotics for 10 days, and all but one successfully recovered.
Meanwhile, the success rate stood at 86 percent in the second largest study.
When the results of both studies were pooled,t revealed that 40 percent of patients treated with antibiotics later required a appendectomy.
The researchers wrote: ‘More than half of the patients treated without surgery experienced no recurrence and avoided surgery for approximately two decades.
“There is no evidence of long-term risks of nonsurgical management other than recurrence of appendicitis.”
However, they noted that the diagnostic standards of operations at that time differed from those of today.
Doctors perform “much higher imaging rates” now, they added, which means fewer patients are misdiagnosed with appendicitis.
The NHS says that around 50,000 people in England are admitted to hospital each year with appendicitis.
Approximately 11.6 million cases of appendicitis are reported annually in the US.
If left untreated, the condition can be fatal.
During surgery, the appendix is removed from the body after doctors make three or four small incisions in the abdomen.
The cuts are closed with staples or stitches.
After routine surgery, most patients can go home the next day and return to normal activities after a week.
But as with any surgery, there are risks. About one in 10 patients suffer from side effects of the operation itself, such as getting a skin infection.
In recent years, several European studies have shown that most people with appendicitis can be successfully treated with antibiotics instead of having surgery.
Seven years ago, experts declared that it was “time to consider” abandoning routine appendectomies.
Hundreds of children have their organs removed unnecessarily each year.