{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T06:01:59Z","timestamp":1793340119775,"version":"4.5.0"},"reference-count":20,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Henan Provincial Key R&D Program","award":["SBGJ202502049"],"award-info":[{"award-number":["SBGJ202502049"]}]},{"name":"the Key R&D Program of Henan Province","award":["231111311600"],"award-info":[{"award-number":["231111311600"]}]},{"name":"Zhengzhou Science and Technology for the People Project","award":["2024KJHM0019"],"award-info":[{"award-number":["2024KJHM0019"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Therap Adv Gastroenterol"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Endoscopic retrograde appendicitis therapy (ERAT) has emerged as a minimally invasive approach to treating appendicitis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>This study aimed to assess the long-term safety and efficacy of ERAT and to develop a model predicting 1\u2011year appendicitis recurrence in patients with acute appendicitis, to guide clinical decision-making.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>This is a multicenter retrospective study. Consecutive patients were referred to the three participating centers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A retrospective analysis was conducted on clinical data from 435 patients with acute appendicitis who underwent ERAT at three hospitals between October 2017 and October 2024. Twenty-four clinical variables were screened, and Spearman correlation analysis revealed correlation coefficients exceeding 0.6 between some variables. To address multicollinearity, LASSO regression was employed to identify key predictive factors in the training set. A predictive model was constructed using multivariate logistic regression, and a nomogram was developed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      All ERAT procedures were technically successful, and a clinical success rate of 92.4% was achieved. The median follow-up period was 37\u2009months, and the overall recurrence rate was 16.1%; most recurrences (13%) were observed in the first year. Based on LASSO regression analysis, the final predictors identified were: age &gt;60\u2009years (odds ratio (OR)\u2009=\u20092.981, 95% confidence interval (CI): 1.368\u20136.497,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.006), recurrence appendicitis (OR\u2009=\u20094.048, 95% CI: 1.931\u20138.587,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001), Alvarado score &gt;6 (OR\u2009=\u20095.649, 95% CI: 2.586\u201312.339,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001), fecalith (OR\u2009=\u20092.680, 95% CI: 1.146\u20136.267,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.023), inexperienced operator (OR\u2009=\u20092.286, 95% CI: 1.141\u20134.580,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.020), procedure time &gt;40\u2009min (OR\u2009=\u20092.472, 95% CI: 1.240\u20134.927,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.010), appendix lumen distortion (OR\u2009=\u20097.634, 95% CI: 1.414\u201341.219,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.018), and stent placement (OR\u2009=\u20095.970, 95% CI: 0.121\u20130.793,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.015). Based on these eight predictive factors, a nomogram model was constructed to predict recurrence risk within 1\u2009year after ERAT.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>ERAT is a safe and effective treatment for acute appendicitis. The risk of recurrence is highest within the first year. Eight independent risk factors for recurrence within 1\u2009year after ERAT were identified, and a recurrence risk prediction model based on these predictive factors can assist in future clinical decision-making for ERAT.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17562848251410867","type":"journal-article","created":{"date-parts":[[2026,1,11]],"date-time":"2026-01-11T09:52:29Z","timestamp":1768125149000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Risk factors for appendicitis recurrence after ERAT in patients with acute appendicitis: a multicenter cohort study with long-term follow-up"],"prefix":"10.1177","volume":"19","author":[{"given":"Jiyu","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haipeng","family":"Yuan","sequence":"additional","affiliation":[{"name":"The Affiliated Taian City Central Hospital of Qingdao University, Taian, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianping","family":"Fan","sequence":"additional","affiliation":[{"name":"Jingxing County Hospital, Hebei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miao","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Serajul","family":"Islam","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ning","family":"Su","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haiyang","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rongjuan","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shihe","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianfei","family":"Feng","sequence":"additional","affiliation":[{"name":"Jingxing County Hospital, Hebei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6101-8675","authenticated-orcid":false,"given":"Bingrong","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Zhengzhou University, No. 1 Eastern Jianshe Road, Zhengzhou, Henan 450052, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8313-4343","authenticated-orcid":false,"given":"Dan","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Zhengzhou University, No. 1 Eastern Jianshe Road, Zhengzhou, Henan 450052, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,1,11]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.20502"},{"key":"e_1_3_4_3_2","article-title":"Endoscopic retrograde appendicitis therapy: current and the future","volume":"12","author":"Liu D","year":"2024","unstructured":"Liu D, Zhang J, Liu B. 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