Comparison of Outcome of Non-operative versus Operative Management of Appendicular Lump in Andhra Pradesh Population
Background: Recent clinical trials suggest that non-operative management of patients with acute uncomplicated appendicitis
is an acceptable alternative to surgery but in complicated appendicitis surgery becomes mandatory. Hence, un-complicated and
complicated appendicitis has to be evaluated.
Materials and Methods: Out of 60 patients, 19 (31.6%) were in emergency Group I and 41 (68.3%) Group II. Group II again
divided into 2A and 2B. The 2B underwent surgery after certain time when antibiotics were ineffective. Every patient were analyzed
on the basis of the previous history, USG and routine blood examination were carried out.
Results: Both Groups I and II were compared. The clinical manifestations – duration of symptoms observed 6.70 in Group I,
9.60 in Group II body temperature (°C) – 37.1 in Group I, and 36.7 in Group II.
Heart rate (pulse/min) 87.5 in Group I 85.7 in Group II. WBC count 13,250 in Group I, 13,2012 in Group II size of abscess (cm)
4.39 in Group I 4.90 in Group II was recorded. In comparative study of surgical out come in both groups (Group I and Group 2A).
Appendectomy – 15 in Group I 25 in Group 2A, Ileoctomy – 03 in Group 2A, Right Hemicolectomy – 02 in Group 2A. Operation
timings (minutes) – 105.70 in Group I, 89.17 in Group 2A. Post operative complications – 4 patients Group I 5 in Group 2A. Postoperative
hospital stay 9.45 in Group I and 9.2 in Group 2A was observed.
Conclusion: Laparoscopic appendectomy is a cost-effective treatment for acute un-complicated appendicitis over lifetime horizon.
In patients of non-operative management were initially tried with antibiotics for certain time if antibiotics are ineffective ultimately
laparoscopic appendectomy is an ideal method.