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Colegio de Medicos y Cirujanos República de Costa Rica
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2015, Number 614

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Rev Med Cos Cen 2015; 72 (614)

El manejo médico de la apendicitis aguda

Gil-Collado M
Full text How to cite this article

Language: Spanish
References: 14
Page: 211-216
PDF size: 65.99 Kb.


Key words:

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ABSTRACT

Acute appendicitis is the most common surgical emergency and although the gold standard is appendectomy, recent studies have documented that antibiotics can be used for its treatment and this has lead to an increasing interest in the study of its efficacy.
Methods: A revision of 7 studies comparing antibiotics vs. appendectomy and 3 studies of antibiotic treatment alone was done.
Results: Antibiotic treatment has a 64-73% efficacy compared to a 95.6% for appendectomy.
Conclusions: Although medical treatment of appendicitis reduces the risk of complications, the literature available still doesn´t justify its use as primary treatment.


REFERENCES

  1. Ansaloni L, Catena F et al. Surgery vs. Conservative Antibiotic Treatment in Acute Appendicitis: A Systematic Review and Meta- Analysis of Randomized Controlled Trials. Dig Surg 2011;28:210–21

  2. Fitzmaurice G, McWilliams B, et al. Antibiotics versus appendectomy in the management of acute appendicitis: a review of the current evidence. Can J Surg 2011 (54) 307- 14

  3. Hansson J, Körner U et al. Antibiotics as First-line Therapy for Acute Appendicitis: Evidence for a Change in Clinical Practice World J Surg (2012) 36:2028–36

  4. Hansson J, Körner U et al. Randomized clinical trial of antibiotic therapy versus appendicectomy as primary treatment of acute appendicitis in unselected patients. British Journal of Surgery 2009; 96: 473–81

  5. Hurme S, Dean K et al. A prospective randomized controlled multicenter trial comparing antibiotic therapy with appendectomy in the treatment of uncomplicated acute appendicitis (APPAC trial) Paajanen et al. BMC Surgery 2013, 13:3

  6. Liu K, Ahanchi S, Pisaneschi M, Lin I. Can Acute Apendicitis be Treated by Antibiotics Alone? The American Surgeon 2007 (73) 1161-65

  7. Liu K y Fogg L. Use of antibiotics alone for treatment of uncomplicated acute

  8. apendicitis: A systematic review and meta-analysis. Surgery 2011 (150) 673-81

  9. Park H, Kim B et al. Efficacy of Short-Term Antibiotic Therapy for Consecutive Patients with Mild Appendicitis. The American Sugeon 2011 (77) 752-55

  10. Paudel GR, Agrawal CS, et al. Conservative Treatment in Acute Appendicitis. J Nepal Med Assoc 2010;50(180):295-9

  11. Styrud J, Eriksson S, Nilsson I et al. Appendectomy versus Antibiotic Treatment in Acute Appendicitis. A Prospective Multicenter Randomized Controlled Trial. World J Surg (2006) 30: 1033–37

  12. Turhan A, Kapan S, et al. Comparison of operative and non operative management of acute appendicitis. Ulus Travma Acil Cerrahi Derg 2009;15(5):459-62

  13. Varadhan K, Humes D. Antibiotic Therapy Versus Appendectomy for Acute Appendicitis: A Meta- Analysis. World J Surg (2010) 34:199–209

  14. Varadhan K Neal K, Safety and efficacy of antibiotics compared with appendicectomy for treatment of uncomplicated acute appendicitis: meta-analysis of randomised controlled trials. BMJ 2012;344:e2156




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Rev Med Cos Cen. 2015;72