98 - Freie Mitteilung
17. Mai 2019, 14:15 - 15:45, Kursaal Arena, 5. OG
High risk of underlying neoplasia in complicated appendicitis
A. Litchinko, A. Miftaroski, B. Egger, Presenter: A. Litchinko (Fribourg)
Appendectomy is one of the most frequent routine operation performed nowadays. At histological examination of the resected specimens, neoplasia of the appendix is found in 1-2%. Recent studies have demonstrated that the risk of neoplasia in patients with complicated appendicitis, abscess formation and >40 years of age is up to 29%.
We present here a retrospective study of data out of a prospective database with 20 adult patient undergoing interval appendectomies after drainage for complicated appendicitis with abscess formation during a 11-year period at a single regional hospital. In a previous study, published in 2017, we presented a cohort of 15 patients with complicated appendicitis and abscess formation undergoing a two-step procedure with initial drainage and then interval appendectomy. In this study we already underlined the high risk of an underlying malignant neoplasia in this population. In the present study, 5 more patients have been added to our already published cohort and data evaluated again.
20 patients were treated for complicated appendicitis with drainage and undergoing then interval appendectomy. Among them, 2 patients (10%) were diagnosed with malignant neoplasia. Considering only patients >40 years of age, this value rises up to 15%.
In summary, our results are consistent with recent findings in the literature. Despite the persistent controversy what concerns the treatment of complicated appendicitis, this study strongly suggest that interval appendectomy should be performed shortly after conservative management (drainage) due to the high risk of a possible underlying malignant neoplasia; especially in patients > 40 years of age.