Title : Efficacy of antibiotic therapy alone versus antibiotics with percutaneous drainage in periappendiceal abscess: A systematic review and meta-analysis
Abstract:
Introduction: Acute appendicitis is one of the most common surgical emergencies. Simple appendicitis can be a complicated periappendiceal abscess. Despite the fact that there are several treatment options for periappendiceal abscesses, there is no consensus on the optimal treatment method; some surgeons prefer appendectomy, while others prefer relying on non-operative approaches using antibiotic therapy with or without percutaneous drainage.
Methods: A meta-analysis was performed for the length of hospital stay and treatment success rate. The analysis was performed using RevMan 5.4 software (Cochrane Collaboration, Oxford, UK). The mean diference with a 95% confdence interval was used to compare the two groups. Furthermore, the odds ratio for the treatment success rate was done using a random-efects model and Mantel-Haenszel method to compare the two groups. The heterogeneity among the studies was assessed using the I2 value; an I2 value of more than 75% refected high heterogeneity among the studies.
Conclusion: antibiotics-only therapy had a slightly higher odds ratio in terms of treatment success, but this was not statistically signifcant. In addition, patients in the antibiotics-only group had a decreased length of hospital stay. On the other hand, patients in the antibiotics plus percutaneous drainage group had lower rates of recurrence and required fewer interval appendectomies. More welldesigned randomized controlled trials are needed to further solidify the evidence.
