The major primary outcomes show a high recurrence rate and failed treatment associated with the conservative management of appendicitis .
The other outcomes obtained show that there is an increased incidence of complications associated with operative management .
Economic implication s and cost-effectiveness analysis show that conservative treatment may be preferred .
The length of hospital stay was significantly higher in conservative approach to management ; however , shorter time off activities was observed .
Appendicectomy has been accepted as the gold st and ard for the management of appendicitis over the years , but there has been an increasing evidence and trend toward the conservative approach to the management of appendicitis .
The aim of this review is to search existing literature and to evaluate and compare the conservative and operative approaches to the management of appendicitis .
Randomized controlled trial of appendicectomy versus antibiotic therapy for acute appendicitis
In a prospect i ve controlled study the effect of antibiotics as the only treatment in acute appendicitis was evaluated . Of 40 patients admitted with a duration of abdominal pain of less than 72 h , 20 received antibiotics intravenously for 2 days followed by oral treatment for 8 days and 20 considered as controls were r and omized to surgery . All patients treated conservatively were discharged within 2 days , except one who required surgery after 12 h because of peritonitis secondary to perforated appendicitis . Seven patients were readmitted within 1 year as a result of recurrent appendicitis and underwent surgery , when appendicitis was confirmed . The diagnostic accuracy within the operated group was 85 per cent . One patient had perforated appendicitis at operation .  Antibiotic treatment  in patients with  acute appendicitis was as effective as surgery . The patients had less pain and required less analgesia , but the recurrence rate was high
The major primary outcomes show a high recurrence rate and failed treatment associated with the conservative management of appendicitis .
The other outcomes obtained show that there is an increased incidence of complications associated with operative management .
Economic implication s and cost-effectiveness analysis show that conservative treatment may be preferred .
The length of hospital stay was significantly higher in conservative approach to management ; however , shorter time off activities was observed .
Appendicectomy has been accepted as the gold st and ard for the management of appendicitis over the years , but there has been an increasing evidence and trend toward the conservative approach to the management of appendicitis .
The aim of this review is to search existing literature and to evaluate and compare the conservative and operative approaches to the management of appendicitis .