Outcomes of Non-Operative Management Versus Early Surgery in Patients with Uncomplicated Appendicitis: A Prospective Comparative Study

Abdullah  Khan; Muhammad Iqbal  Khan; Maria  Mahmood; Riffat  Arbab; Aisha  Arshad; Rukhsar  Anwar

doi:10.54112/bcsrj.v6i6.1956

Authors

Abdullah Khan Department of Surgery, Bolan Medical College, Quetta, Pakistan
Muhammad Iqbal Khan Department of Surgery, Postgraduate Medical Institute, Quetta, Pakistan
Maria Mahmood Department of Surgery, Bolan Medical College, Quetta, Pakistan
Riffat Arbab Department of Surgery, Bolan Medical College, Quetta, Pakistan
Aisha Arshad Department of Surgery, Bolan Medical College, Quetta, Pakistan
Rukhsar Anwar Department of Surgery, Teaching Hospital Sibi, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v6i6.1956

Keywords:

uncomplicated appendicitis, non-operative management, laparoscopic appendectomy, recurrence

Abstract

The optimal management of uncomplicated appendicitis remains debated, with increasing interest in non-operative management (NOM) as an alternative to early surgery. Objective: This study compares clinical outcomes of NOM versus early surgical intervention in patients with imaging-confirmed uncomplicated appendicitis. Methods: This prospective comparative study was conducted at Bolan Medical College, Quetta, from July 2024 to December 2024. Ninety-five patients aged 15–60 years with ultrasonography or computed tomography-confirmed uncomplicated appendicitis were included. Patients were allocated to NOM (n = 47; intravenous ceftriaxone and metronidazole followed by oral antibiotics) or early surgery (n = 48; laparoscopic appendectomy within 24 hours). Results: Primary treatment success was achieved in 89.4% of NOM patients versus 100% of surgical patients (p = 0.026). Recurrence within six months occurred in 16.7% of NOM patients, whereas no recurrences were observed in the surgical group (p = 0.003). Complications during index admission were significantly lower in the NOM group (6.4% vs 18.8%, p = 0.049). Mean hospital stay was shorter for NOM (2.1 ± 0.9 days) compared to surgery (3.4 ± 1.2 days, p < 0.001). Readmission rates did not differ significantly (10.6% vs 4.2%, p = 0.21). Conclusion: Non-operative management is a safe and effective initial strategy for selected patients with uncomplicated appendicitis, offering fewer short-term complications and reduced hospitalisation. However, the risk of recurrence remains an important consideration.

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References

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