Why quick surgery is better than antibiotics alone

It is hard to believe: In the last two decades, great efforts have been made to prove that antibiotic therapy is better than laparoscopic (minimally invasive) surgery for mild appendicitis.

What is the appendix? When does appendicitis occur?

The appendix is a more or less pointless appendix on the large intestine in the right lower abdomen. It is between 5-10 centimetres long, about one centimetre wide and can become inflamed at any time. The reasons for infection are always debated. The fact is that appendicitis can occur in early childhood as well as in old age, practically at any time.

How do you notice an appendicitis?

It usually starts with diffuse abdominal pain and loss of appetite, sometimes nausea and vomiting. The pain then moves to the right lower abdomen. Later, fever and a rapid pulse may also occur.

It is important to go to a hospital emergency quickly. If the clinical examination by the doctor is clear and the situation is urgent, surgery may be performed immediately. However, an ultrasound scan or computer tomography is often performed to confirm the diagnosis or to exclude other causes for the abdominal pain.

How we treat appendicitis in the swiss1chirurgie clinic

Rapid surgery is the best therapy! This is also confirmed by a study just published in October 2018 in the well-known journal “Surgery”. The study uses a large American database to describe the safety of a rapid laparoscopic appendectomy (appendectomy, through three small incisions with minimally invasive instruments). This solves the problem once and for all. Antibiotic therapy alone in uncomplicated appendicitis (i.e. only mild infection) is often advocated, but the initial success rate is at most 75%. The risk of having another infection afterwards is almost 20%.

Antibiotics are therefore only given directly before the operation and are only necessary after an operation if the appendix had already broken through (perforation, pus discharge, abscess). Antibiotic therapy for 5-7 days is then necessary, possibly even with inpatient intravenous administration.

More about the swiss1chirurgie clinic, appendicitis and other of our focal points at www.drzehetner.ch. You can find out more about the Centre for Bariatric Surgery at www.zfbc.ch.