Appendicitis is a medical condition in which the appendix (a small tube-like organ attached to the large intestine) becomes inflamed or infected. The human appendix, previously thought to be a vestigial or evolutionary remnant has been found to play a significant role in the digestive and immune systems according to recent studies.
Despite its useful functions in the body, removal of the infected appendix is recommended by doctors as untreated appendicitis can be fatal. Furthermore, its removal is not harmful to the human body.
Since time immemorial, surgery has been the standard treatment for appendicitis. It was by the end of the 20th century that laparoscopic surgery replaced open surgery in most cases. Laparoscopic appendectomy is now considered one of the least complicated and safest surgical procedures performed today. This minimally invasive technique is not only less painful but also helps in quick healing. However, in extreme cases where the appendix ruptures, major abdominal surgery or laparotomy is the recommended procedure.
The biggest question lies in whether appendicitis can be treated without surgery. The answer to this question depends upon the severity of the patient. Treatment for appendicitis is not one-size-fits-all. Studies reveal that some patients may recover from appendicitis with antibiotics only if the infection is mild. But, for patients suffering from appendicitis with an appendicolith, a firm stone-like material inside the appendix, surgery is the only option. In such cases, the appendix must be surgically removed in order to prevent further complications.
During the Cold War, antibiotics were used to treat appendicitis on submarines instead of an appendectomy as the submarines could not surface for six months or more. In a 2012 clinical trial, antibiotics alone were used to treat most patients with uncomplicated acute appendicitis (appendicitis without rupture, pus-filled abscesses, or peritonitis) and they did not require surgery during the one-year follow-up period.
According to a 2015 study, the “antibiotics-first” approach was useful for patients with complications from prior surgery. Another study conducted the same year revealed that about 27 percent of patients who received antibiotic treatment had to undergo an appendectomy within a year. In a study published in 2018, 60 percent of people who were treated with antibiotics remained disease-free for 5 years afterwards.
There is much debate over whether non-operative treatment of uncomplicated appendicitis is a viable alternative to an appendectomy, but some researchers believe it is. However, non-operative treatment is also associated with an increased risk of recurrent appendicitis accompanied by hospital readmissions resulting in additional expenditure. While further research is needed to determine the long-term efficacy of non-operative treatment, appendectomy is considered the gold standard of treatment due to its high success rate.
This blog has been written by Delhi’s leading laparoscopic surgeon for the appendix Dr Amita Jain.
Dr Amita Jain is a surgeon with highest degree of professional competence, precision and surgical craftsmanship. Performed all complicated general surgery procedures with in depth knowledge of invasive and few minimal invasive and onco surgical techniques. Underwent special training in trauma, executed various trauma-related complex life-saving neurosurgical procedures, reconstructed injured mangled limbs and performed vascular and reconstructive procedures with critical care.
Dr Amita Jain holds 28 plus years of rich experience in Trauma and General Laparoscopic Surgeries (including Gallbladder stone removal, appendix removal, hernia repair surgery, piles and fissure surgeries). She was the Professor Surgery of at the Army College of Medical Sciences and Base Hospital Delhi Cantt. In 1994 she was commissioned as Surgeon under the United Nations Mission in Congo. From 2020 to 2022, she worked with Bansals Hospital. Currently, Dr Amita Jain is the Senior Consultant, (Speciality: General and Laparoscopic Surgeon) at Artemis Lite Hospital, New Delhi