An appendectomy, which is currently one of the most common procedures performed by the NHS, may soon become obsolete according to Swedish experts. They argue that antibiotics can effectively treat appendicitis, eliminating the need for surgery. The researchers at the Karolinska Institute found that the only risk of relying on antibiotics is the possibility of a recurrence of appendicitis. In their analysis, they discovered that less than half of the patients treated with antibiotics experienced another flare-up. This finding is significant as it aligns with the ongoing effort to reduce NHS inpatient costs and unnecessary procedures.
The experts conducted their research using data from two controlled trials in the Swedish National Patient Registry, involving a total of 292 patients with appendicitis. The condition, characterized by severe abdominal pain that shifts to the lower right-hand side, can be life-threatening if not promptly treated. In one study, forty patients were split into two groups, with half undergoing an appendectomy and the other half receiving a ten-day course of antibiotics. All but one of the patients who received antibiotics successfully recovered. In the second, larger study, the success rate stood at 86 percent. Combining the results of both studies, it was determined that 40 percent of patients treated with antibiotics eventually required an appendectomy.
The researchers also noted that over a two-decade period, more than half of the patients treated without surgery did not experience a recurrence of appendicitis. They emphasized that there is no evidence of long-term risks associated with nonoperative management, except for the possibility of appendicitis returning. However, they acknowledged that the standards for diagnosing and treating the condition have evolved, and today’s practices involve higher rates of imaging, resulting in fewer misdiagnosed cases.
Currently, about 50,000 people in England are admitted to the hospital each year due to appendicitis, and approximately 11.6 million cases are reported annually in the US. If left untreated, appendicitis can be fatal. During an appendectomy, the appendix is removed through small incisions in the abdomen. Although it is a routine surgery, there are inherent risks, with about one in ten patients experiencing side effects like skin infections.
In recent years, several European studies have shown that antibiotics can successfully treat most cases of appendicitis, eliminating the need for surgery. This led experts to suggest reevaluating the routine use of appendectomies. Currently, many unnecessary appendectomies are performed on children. However, with the growing evidence supporting antibiotic treatment as a viable alternative, the removal of the appendix may become a thing of the past.
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