- An appendectomy is one of the most common procedures carried out by NHS
- Researchers say the only risk of not operating is appendicitis later recurring
Operations to remove the appendix could soon become a thing of the past.
Swedish experts claim appendicitis — when the mysterious, worm-shaped organ gets infected — can be treated effectively with antibiotics.
It could spell the end of the appendectomy, one of the most common procedures carried out by the NHS.
Swift removal of the appendix has been standard treatment for over a century.
But researchers at the Karolinska Institute argue the only risk of not operating and relying on antibiotics is another appendicitis flare-up.
Swedish experts say the only risk of not operating and relying on drugs instead is appendicitis recurring. Their analysis of evidence found fewer than half of patients treated with antibiotics were struck down again
The researchers, from the Karolinska Institute in Stockholm, used data from two random controlled trials in the Swedish National Patient Registry. Pictured: Stock image highlighting the location of an inflamed appendix
The findings come amid a subtle push to reduce NHS inpatient costs and the number of procedures carried out by the health service.
Writing in the journal JAMA surgery, the team said: ‘The present data will further be beneficial to clinicians as well as patients in making a treatment decision.’
Experts analysed two separate trials, which assessed the outcomes of 292 patients hospitalised with appendicitis.
The condition, which causes stomach pain that travels to the lower right-hand side, can be life-threatening without quick treatment.
Forty sufferers were divided into two groups as part of the first study. Half received an appendectomy.
WHAT IS APPENDICITIS?
Appendicitis is a swelling of the appendix, a two to four-inch-long organ connected to the large intestine.
Appendicitis can cause severe pain and it’s important for it to be treated swiftly in case the appendix bursts, which can cause life-threatening illness.
In most cases surgeons will remove the appendix in an appendectomy – scientists aren’t sure why people need an appendix but removing it does not harm people.
The causes of appendicitis aren’t clear but it is thought to be caused by something blocking the entrance to the organ.
Symptoms include pain in the stomach which later travels to your lower right-hand-side and becomes severe.
Pressing on this area, coughing, or walking can all make the pain worse, and other symptoms can be nausea, vomiting, loss of appetite, diarrhoea and a fever.
The others got antibiotics for 10 days, with all but one recovering successfully.
Meanwhile, the success rate stood at 86 per cent in the second, bigger study.
When results from both studies were pooled, it revealed that 40 per cent of patients treated with antibiotics did later require an appendectomy.
The researchers wrote: ‘More than half of the patients treated nonoperatively did not experience recurrence and avoided surgery over approximately two decades.
‘There’s no evidence for long term risks of nonoperative management other than that of recurrence of appendicitis.’
They did, however, note the diagnostic standards of operations at the time, differed to today.
Medics undertake ‘much higher rates of imaging’ now, they added, meaning fewer patients are misdiagnosed with appendicitis.
The NHS says around 50,000 people in England are admitted to hospital each year with appendicitis.
Approximately 11.6million cases of appendicitis are reported annually in the US.
If left untreated, the condition can be fatal.
During surgery, the appendix is removed from the body after doctors make three or four tiny incisions in the abdomen.
The cuts are closed with staples or stitches.
After the routine surgery, most patients are able to go home the next day and return to normal activities after a week.
But as with any surgery, there are risks. Around one in 10 patients suffer side effects from the operation itself, such as catching a skin infection.
In recent years, several European studies have shown most people with appendicitis can be treated successfully with antibiotics instead of having surgery.
Seven years ago, experts declared that it was ‘time to consider’ abandoning routine appendectomies.
Hundreds of kids needlessly get the organ removed every year.