{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T07:04:10Z","timestamp":1785308650175,"version":"3.55.0"},"reference-count":14,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T00:00:00Z","timestamp":1775692800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The management of an appendiceal inflammatory mass (historically termed \u201cplastron\u201d) is controversial due to debates over optimal treatment strategies and malignancy risk. This 15-year retrospective study compares medical vs surgical outcomes, provides granular malignancy data, and aims to establish a risk-stratified surveillance protocol.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods<\/jats:title>\n                    <jats:p>This STROBE-compliant retrospective study analyzed 79 consecutive patients (2009-2024) with radiologically confirmed appendiceal inflammatory masses at University of Health Sciences, \u00dcmraniye Training and Research Hospital. We performed propensity score-adjusted comparisons between medical (antibiotics \u00b1 percutaneous drainage, n = 32) and surgical (n = 47) groups. Outcomes focused on success rates, complications, hospital stay, malignancy (histopathology), and colonoscopic findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Medical management was initially successful (68.7%, 22\/32), resulting in significantly shorter hospitalization (mean difference 2.8 days, 95% CI: 0.2\u20145.4, 4.1 \u00b1 2.7 vs 6.9 \u00b1 4.8 days,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.03) and fewer complications (OR 0.35, 95% CI: 0.1\u20140.9, 9.3% vs 23.4%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.04) vs surgery. Interval appendectomy was required in 31.2% (10\/32) of medical patients. Malignancies were identified in 15.1% overall (95% CI: 7.9%\u201424.9%), including 6.2% diagnosed only at interval appendectomy. Colonoscopy was performed in 31.6% (25\/79) and detected significant neoplasia in 20.0% (5\/25; 95% CI: 8.9%\u201339.1%), predominantly among clinically high-risk patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Conservative management is effective, but the substantial malignancy risk (15.1%) and high colonoscopy yield (19%) in this high-risk tertiary cohort necessitate vigilant surveillance. Consistent with updated screening guidance, we recommend colonoscopic evaluation for patients aged \u226545 and\/or those with elevated tumor markers or suspicious imaging, and a lower threshold for interval appendectomy in high-risk phenotypes, supporting a risk-stratified approach.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348261441674","type":"journal-article","created":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T05:31:23Z","timestamp":1775799083000},"page":"2378-2386","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Management of Appendiceal Inflammatory Mass: Nonoperative Treatment, Malignancy Risk, and Surveillance"],"prefix":"10.1177","volume":"92","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1319-9114","authenticated-orcid":false,"given":"\u0130lyas","family":"Kuda\u015f","sequence":"first","affiliation":[{"name":"Cam Sakura Training and Research Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1433-3431","authenticated-orcid":false,"given":"Olgun","family":"Erdem","sequence":"additional","affiliation":[{"name":"Umraniye Training and Research Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1854-7437","authenticated-orcid":false,"given":"Fatih","family":"Ba\u015fak","sequence":"additional","affiliation":[{"name":"Umraniye Training and Research Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeynep \u015eevval","family":"Ali\u015f","sequence":"additional","affiliation":[{"name":"Umraniye Training and Research Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H\u00fcsna","family":"Tosun","sequence":"additional","affiliation":[{"name":"Umraniye Training and Research Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yahya Kemal","family":"Cal\u0131\u015fkan","sequence":"additional","affiliation":[{"name":"Istanbul Kanuni Training and Research Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aylin","family":"Acar","sequence":"additional","affiliation":[{"name":"Umraniye Training and Research Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tolga","family":"Canbak","sequence":"additional","affiliation":[{"name":"Umraniye Training and Research Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huseyin Kerem","family":"Tolan","sequence":"additional","affiliation":[{"name":"Umraniye Training and Research Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kemal","family":"Teke\u015fin","sequence":"additional","affiliation":[{"name":"Umraniye Training and Research Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,4,9]]},"reference":[{"key":"e_1_3_7_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2005.03.046"},{"key":"e_1_3_7_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1318.2007.01377.x"},{"key":"e_1_3_7_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-014-2460-1"},{"key":"e_1_3_7_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-006-0056-y"},{"key":"e_1_3_7_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.10589"},{"key":"e_1_3_7_7_2","doi-asserted-by":"publisher","DOI":"10.18203\/2349-2902.isj20212724"},{"key":"e_1_3_7_8_2","doi-asserted-by":"publisher","DOI":"10.3393\/ac.2023.00528.0075"},{"key":"e_1_3_7_9_2","doi-asserted-by":"publisher","DOI":"10.5946\/ce.2025.022"},{"key":"e_1_3_7_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13304-024-01801-x"},{"key":"e_1_3_7_11_2","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.70480"},{"key":"e_1_3_7_12_2","article-title":"Reinforcement Learning-based Automatic Diagnosis of Acute Appendicitis in Abdominal CT","author":"Al AW","year":"2019","unstructured":"Al AW, Yun ID, Lee KJ. Reinforcement Learning-based Automatic Diagnosis of Acute Appendicitis in Abdominal CT. arXiv:1909.00617v1 eess.IV. 2019.","journal-title":"arXiv:1909.00617v1 eess.IV"},{"key":"e_1_3_7_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2007.11.008"},{"key":"e_1_3_7_14_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm14124264"},{"key":"e_1_3_7_15_2","article-title":"Interpretable Ultrasound-based ML Models for Appendicitis","author":"Marcinkevi\u010ds R","year":"2023","unstructured":"Marcinkevi\u010ds R, Wolfertstetter PR, Klimiene U, et al. Interpretable Ultrasound-based ML Models for Appendicitis. arXiv:2302.14460v3 [cs.LG]. 2023.","journal-title":"arXiv:2302.14460v3 [cs.LG]"}],"container-title":["The American Surgeon\u2122"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348261441674","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00031348261441674","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348261441674","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T06:19:35Z","timestamp":1785305975000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00031348261441674"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,9]]},"references-count":14,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1177\/00031348261441674"],"URL":"https:\/\/doi.org\/10.1177\/00031348261441674","relation":{},"ISSN":["0003-1348","1555-9823"],"issn-type":[{"value":"0003-1348","type":"print"},{"value":"1555-9823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,9]]}}}