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Chinese Journal of Gastrointestinal Endoscopy(Electronic Edition) ›› 2024, Vol. 11 ›› Issue (01): 7-12. doi: 10.3877/cma.j.issn.2095-7157.2024.01.003

• Original Article • Previous Articles    

Preliminary study on the curative effect of endoscopic treatment of acute appendicitis based on the concept of super minimally invasive surgery

Lijuan Mao1, Ting Zhang1, Renhu Sun1, Dapeng Wu1, Hailin Jin1, Xiaoyun Lu1, Wenjie Li1, Tingsheng Ling1, Qide Zhang1,()   

  1. 1. Digestive Endoscopy Center, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, China
  • Received:2023-09-18 Online:2024-02-15 Published:2024-04-12
  • Contact: Qide Zhang

Abstract:

Objective

To explore the preliminary effect of endoscopic treatment of acute appendicitis based on the concept of super-minimally invasive technique.

Methods

The study was performed on 7 patients who underwent endoscopic therapy for acute appendicitis at Jiangsu Province Hospital of Chinese Medicine from September 2022 to May 2023.The methods of treatment, success rate, operation duration, hospital stay, complications, symptom remission and recurrence were analyzed retrospectively.

Results

A total of 7 patients with acute appendicitis were collected, including 6 acute uncomplicated appendicitis: One case of impacted appendiceal fecalith incarceration underwent endoscopic appendiceal orifice myotomy and lithotomy; One case of appendix abscess was treated by drainage of pus and decompression with endoscopic appendiceal orifice myotomy; 4 patients with acute appendicitis underwent endoscopic retrograde appendicitis therapy (ERAT, including irrigation、stent placement、basket lithotomy), in one case, endoscopic retrograde appendiceal exploration and lavage were operated with the auxiliary eyeMax. One case of complicated appendicitis with peripheral abscess was treated with ERAT and stent drainage. The average procedure time was 30.43 min. Averagely, abdominal pain was relieved one day after the procedure, and all endoscopic treatments in these patients were successful. The average allowable feeding time after surgery was 2 days. The average post-operative hospital stay was 6.14 days. No recurrence occurred during 4 to 12 months′ follow-up, except the case with peripheral abscess undergoing elective surgical appendectomy.

Conclusion

Based on the super-minimally invasive concept, endoscopic minimally invasive treatment of acute appendicitis is safe and effective in various ways, but further controlled studies are needed.

Key words: Appendicitis, Super-minimally invasive concept, Endoscopic appendiceal orifice myotomy, Endoscopic retrograde appendicitis therapy

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