Laparoscopic versus conservative treatment of appendicular mass: outcome and benefit comparisons

Context
Appendicular mass is one of the most common surgical problems and constitutes ∼2–6% of cases presented with acute appendicitis. Management is still controversial, with three different approaches: emergency surgery, conservative management followed by interval surgery, and totally conservative management without interval surgery. Recently, laparoscopic appendectomy has become the preferred method in the management of acute appendicitis; however, its role in the management of complicated appendicitis is still debatable.
Aims
The current study aimed to assess the outcome, benefit, and feasibility of laparoscopic surgery versus conservative approach for management of appendicular mass.
Patients and methods
This double-blinded randomized controlled trial study included 60 patients with appendicular mass, recruited from the emergency unit at Sohag University Hospital during the period from January 2019 to February 2021. They were randomly assigned into two groups: group A patients underwent laparoscopic and group B patients underwent conservative management.
Results
There was a significant difference between groups A and B cases regarding hospital stay (group A, 6.6±0.7 days vs. group B, 10±1.6 days; <0.001) and outcome, with respect to peritonitis (group A, 40% vs. group B 0%; <0.001) and improvement (group A 100% vs. group B 40%; <0.001). There was no significant difference between the two study groups regarding clinical picture.
Conclusions
Laparoscopic appendectomy is a feasible and safe approach in patients with early appendicular mass. Laparoscopic appendectomy for mass is a feasible and safe approach with better outcome and shorter hospital stay compared with conservative modality.