Male Gender is a Risk Factor for Recurrent Appendicitis Following Nonoperative Treatment
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To the Editor,
We read with great interest the article by Lien et al.  in which the authors analyzed a cohort of 128 patients with appendicitis. The method of patient selection is not reliable, however, because it is not randomized and “the patients decided whether to receive operative or non-operative treatment, after the staff surgeons explained advantages and risks of surgical intervention and non-operative treatment based on their age and medical status.” Possible bias could result from such patient selection (not based on randomization). Also, such a study would ideally be a prospective observation, which should include only consecutive and unselected patients with the same diagnosis. Also relevant is the way the treating surgeon explained risk and benefits of the two treatment options, as this information might affect a patient’s choice.
Further, in defining differences in recurrence between males and females in the series, no data are given regarding possible significant...
KeywordsEndometriosis Appendicitis Acute Appendicitis High Recurrence Rate Pelvic Inflammatory Disease
- 6.Tugnoli G, Giorgini E, Biscardi A, et al. (2011) The NOTA study: non-operative treatment for acute appendicitis: prospective study on the efficacy and safety of antibiotic treatment (amoxicillin and clavulanic acid) in patients with right sided lower abdominal pain. BMJ Open. doi: 10.1136/bmjopen-2010-0000