Bing-Rong Liu1, Ji-Tao Song, Fu-You Han, Hui Li, Ji-Bin Yin. 1. Digestive Endoscopy Center, Department of Gastroenterology and Hepatology, The Second Affiliated Hospital of Harbin Medical University, Harbin, People's Republic of China. 13704510648@126.com
Abstract
BACKGROUND: Inspired by the success of ERCP for the treatment of suppurative cholangitis, we investigated a new minimally invasive method for the treatment of acute uncomplicated appendicitis, which we call endoscopic retrograde appendicitis therapy. OBJECTIVE: To investigate the feasibility and efficacy of endoscopic retrograde appendicitis therapy for the treatment of acute uncomplicated appendicitis. DESIGN AND SETTING: A retrospective, single-center study at an academic medical center. PATIENTS: Four patients with acute uncomplicated appendicitis. INTERVENTIONS: There were 5 steps after insertion of a colonoscope into the cecum and identification of the appendiceal orifice: (1) endoscopic appendiceal intubation; (2) appendiceal decompression; (3) retrograde appendicography; (4) stent drainage; and (5) cleansing the appendiceal lumen. MAIN OUTCOME MEASUREMENTS: The rate of successful endoscopic intubation and decompression, the time to symptom relief, the time to disappearance of signs, increased white blood cell count, procedure-related complications, and recurrence, if any. RESULTS: All 4 endoscopic appendiceal intubations were successful. Pain was relieved immediately after endoscopic decompression and stent drainage. Leukocytosis returned to normal within 24 hours. There were no complications and no recurrences during 4 to 19 months of follow-up. LIMITATIONS: Small sample size, single-center study without controls. CONCLUSION: Endoscopic retrograde appendicitis therapy is a feasible and effective endoscopic treatment modality for acute uncomplicated appendicitis.
BACKGROUND: Inspired by the success of ERCP for the treatment of suppurative cholangitis, we investigated a new minimally invasive method for the treatment of acute uncomplicated appendicitis, which we call endoscopic retrograde appendicitis therapy. OBJECTIVE: To investigate the feasibility and efficacy of endoscopic retrograde appendicitis therapy for the treatment of acute uncomplicated appendicitis. DESIGN AND SETTING: A retrospective, single-center study at an academic medical center. PATIENTS: Four patients with acute uncomplicated appendicitis. INTERVENTIONS: There were 5 steps after insertion of a colonoscope into the cecum and identification of the appendiceal orifice: (1) endoscopic appendiceal intubation; (2) appendiceal decompression; (3) retrograde appendicography; (4) stent drainage; and (5) cleansing the appendiceal lumen. MAIN OUTCOME MEASUREMENTS: The rate of successful endoscopic intubation and decompression, the time to symptom relief, the time to disappearance of signs, increased white blood cell count, procedure-related complications, and recurrence, if any. RESULTS: All 4 endoscopic appendiceal intubations were successful. Pain was relieved immediately after endoscopic decompression and stent drainage. Leukocytosis returned to normal within 24 hours. There were no complications and no recurrences during 4 to 19 months of follow-up. LIMITATIONS: Small sample size, single-center study without controls. CONCLUSION: Endoscopic retrograde appendicitis therapy is a feasible and effective endoscopic treatment modality for acute uncomplicated appendicitis.
Authors: Luis Angel Medina Andrade; Franz Yeudiel Pérez Muñoz; María Valeria Jiménez Báez; Stephanie Serrano Collazos; Maria de Los Angeles Martinez Ferretiz; Brenda Ruiz; Oscar Montes; Stephanie Woolf; Jessica Gonzalez Noriega; Uriel Maldonado Aparicio; Israel Gonzalez Gonzalez Journal: World J Surg Date: 2016-11 Impact factor: 3.352