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Non-operative treatment of appendicitis: public perception and decision-making

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Abstract

Background

Appendectomy has for many years been the accepted treatment of appendicitis. In recent years, non-operative management of appendicitis (NOTA) has been reported as an effective treatment option.

Aims

We aimed to assess the perspectives of public hospital attendees regarding the diagnosis and treatment options for appendicitis.

Methods

We conducted a cross-sectional survey of outpatients over a 10-week period (December 2016–March 2017). The questionnaire contained an information sheet and consent form and included open, closed and multiple-choice questions.

Results

Two hundred forty-four participants (159 female, 85 male) were surveyed. A high level of awareness of appendicitis as a surgical emergency existed amongst the participants. The primary reason participants were reluctant to receive non-operative treatment was a fear of their appendix “bursting” if not removed.

Conclusions

Participant knowledge levels were variable with many concerned that non-operated appendicitis would always perforate. Perceptions of treatment were variable with some believing surgery was an absolute requirement and others preferring antibiotics due to the belief that NOTA is complication-free.

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References

  1. Baird DLH, Simillis C, Kontovounisios C, Rasheed S, Tekkis PP (2017) Acute appendicitis. Br Med J (Clin Res Ed) 357:j1703

    Article  Google Scholar 

  2. Perforating FR (1886) Inflammation of the vermiform appendix, with special reference to its early diagnosis and treatment. Am J Med Sci 92:321–346

    Google Scholar 

  3. Di Saverio S, Sibilio A, Giorgini E, Biscardi A, Villani S, Coccolini F, Smerieri N, Pisano M, Ansaloni L, Sartelli M, Catena F, Tugnoli G (2014) The NOTA study (non operative treatment for acute appendicitis): prospective study on the efficacy and safety of antibiotics (amoxicillin and clavulanic acid) for treating patients with right lower quadrant abdominal pain and long-term follow-up of conservatively treated suspected appendicitis. Ann Surg 260(1):109–117. https://doi.org/10.1097/SLA.0000000000000560

    Article  PubMed  Google Scholar 

  4. Andersson RE (2007) The natural history and traditional management of appendicitis revisited: spontaneous resolution and predominance of prehospital perforations imply that a correct diagnosis is more important than an early diagnosis. World J Surg 31(1):86–92. https://doi.org/10.1007/s00268-006-0056-y

    Article  PubMed  Google Scholar 

  5. Bhangu A, Soreide K, Di Saverio S, Assarsson JH, Drake FT (2015) Acute appendicitis: modern understanding of pathogenesis, diagnosis, and management. Lancet (London, England) 386(10000):1278–1287. https://doi.org/10.1016/S0140-6736(15)00275-5

    Article  Google Scholar 

  6. Campbell MR, Johnston SL 3rd, Marshburn T, Kane J, Lugg D (2004) Nonoperative treatment of suspected appendicitis in remote medical care environments: implications for future spaceflight medical care. J Am Coll Surg 198(5):822–830. https://doi.org/10.1016/j.jamcollsurg.2004.01.009

    Article  PubMed  Google Scholar 

  7. Senapathi PS, Bhattacharya D, Ammori BJ (2002) Early laparoscopic appendectomy for appendicular mass. Surg Endosc 16(12):1783–1785

    Article  CAS  Google Scholar 

  8. Findlay JM, Kafsi JE, Hammer C, Gilmour J, Gillies RS, Maynard ND (2016) Nonoperative management of appendicitis in adults: a systematic review and meta-analysis of randomized controlled trials. J Am Coll Surg 223(6):814–24.e2

    Article  Google Scholar 

  9. Chau DB, Ciullo SS, Watson-Smith D, Chun TH, Kurkchubasche AG, Luks FI (2016) Patient-centered outcomes research in appendicitis in children: bridging the knowledge gap. Pediatr Surg 51(1):117–121. https://doi.org/10.1016/j.jpedsurg.2015.10.029

    Article  Google Scholar 

  10. Minneci PC, Mahida JB, Lodwick DL, Sulkowski JP, Nacion KM, Cooper JN, Ambeba EJ, Moss RL, Deans KJ (2016) Effectiveness of patient choice in nonoperative vs surgical management of pediatric uncomplicated acute appendicitis. JAMA Surg 151(5):408–415. https://doi.org/10.1001/jamasurg.2015.4534

    Article  CAS  PubMed  Google Scholar 

  11. Huang L, Yin Y, Yang L, Wang C, Li Y, Zhou Z (2017) Comparison of antibiotic therapy and appendectomy for acute uncomplicated appendicitis in children: a meta-analysis. JAMA Pediatr 171(5):426–434. https://doi.org/10.1001/jamapediatrics.2017.0057

    Article  PubMed  PubMed Central  Google Scholar 

  12. Harnoss JC, Zelienka I, Probst P, Grummich K, Müller-Lantzsch C, Harnoss JM, Ulrich A, Büchler MW, Diener MK (2017) Antibiotics versus surgical therapy for uncomplicated appendicitis: systematic review and meta-analysis of controlled trials (PROSPERO 2015: CRD42015016882). Ann Surg 265(5):889–900. https://doi.org/10.1097/SLA.0000000000002039

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, Mayo University Hospital, Castlebar, Mayo, Ireland

    Emer P. O’Connell, Annmarie White, Paul Cromwell, Waqar Khan, Ronan Waldron, Iqbal Z. Khan & Kevin Barry

  2. Discipline of Surgery, National University of Ireland, Galway, Ireland

    Emma Carroll & Kevin Barry

Authors
  1. Emer P. O’Connell
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  2. Annmarie White
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  3. Paul Cromwell
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  4. Emma Carroll
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  5. Waqar Khan
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  6. Ronan Waldron
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  7. Iqbal Z. Khan
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  8. Kevin Barry
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Corresponding author

Correspondence to Emer P. O’Connell.

Ethics declarations

This study was granted full ethical approval from the Mayo University Hospital Research Ethics Committee.

Conflict of interest

The authors declare that they have no conflict of interest.

Appendix. Survey questionnaire

Appendix. Survey questionnaire

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O’Connell, E.P., White, A., Cromwell, P. et al. Non-operative treatment of appendicitis: public perception and decision-making. Ir J Med Sci 187, 1029–1038 (2018). https://doi.org/10.1007/s11845-018-1758-5

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  • DOI: https://doi.org/10.1007/s11845-018-1758-5

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