KUMJ | VOL. 14 | NO. 3 | ISSUE 55 | JULY-SEPT. 2016
Safe and Feasible Time Limit for Early Appendectomy in Appendiceal Mass
Pandit RK
Abstract: Background
Early appendectomy in appendiceal mass is gaining popularity among some surgeons.
However, it is endowed with increasing operative difficulty with time, and safe and
feasible timing is not yet clear.
Objective
To know safe and feasible time limit for early appendectomy in appendiceal mass.
Method
This is a retrospective study. Between May 2009 and July 2014, 114 patients of
appendiceal mass who underwent early surgical intervention by a single surgeon
were studied. Group I included 98 patients operated within seven days of onset of
pain and group II included 16 patients operated between 8th and 15 days of pain.
Type of operative procedure, difficulties and complications were analyzed.
Result
There were 58 men and 56 women. Their mean age was 24.27 ± 8.7 years. In group
I, 98 (100%) patients had appendectomy and adhesiolysis was safe and feasible. In
group II, 5(31.25%) patients had extra-peritoneal drainage of abscess without attempt
for appendectomy. Remaining 11 patients had attempt for appendectomy, but only
3(18.75%) out of 4 patients operated on the 8th day could have appendectomy. Six
(37.5%) patients had just drainage of abscess. Two (12.5%) patients, operated on
the 12th and 15th days of pain had just open-closed due to dense adhesion and both
resolved. One patient operated on the 10th day sustained ileal injury. Surgical site
infection occurred in 16.6% (14 in 86) in group I and 33.3% (5 in 15) in group B (P=
0.001). Mean operative time was 34.4 ± 9.23 minutes and 43.7 ± 16.38 minutes for
group I and group II respectively. Mean hospital stay after surgery was 2.9 ± 1.1 days
and 5.5 ± 1.37 days in group I and group II respectively.
Conclusion
Early appendectomy in appendiceal mass seems safe and feasible up to 7th day
since onset of pain in my experience. However, this limit may vary with surgeon’s
experience, and further studies are required to better clarify this issue.
Keyword : Appendiceal mass, early appendectomy, safe and feasible timing
