{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T15:06:26Z","timestamp":1787843186086,"version":"build-2784847793"},"reference-count":94,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2024,5,22]],"date-time":"2024-05-22T00:00:00Z","timestamp":1716336000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Globally, acute appendicitis has an estimated lifetime risk of 7\u20138%. However, there are numerous controversies surrounding the management of acute appendicitis, and the best treatment approach depends on patient characteristics. Non-operative management (NOM), which involves the utilization of antibiotics and aggressive intravenous hydration, and surgical appendectomy are valid treatment options for healthy adults. NOM is also ideal for poor surgical candidates. Another important consideration is the timing of surgery, i.e., the role of interval appendectomy (IA) and the possibility of delaying surgery for a few hours on index admission. IA refers to surgical removal of the appendix 8\u201312 weeks after the initial diagnosis of appendicitis. It is ideal in patients with a contained appendiceal perforation on initial presentation, wherein an initial nonoperative approach is preferred. Furthermore, IA can help distinguish malignant and non-malignant causes of acute appendicitis, while reducing the risk of recurrence. On the contrary, a decision to delay appendectomy for a few hours on index admission should be made based on the patients\u2019 baseline health status and severity of appendicitis. Post-operatively, surgical drain placement may help reduce postoperative complications; however, it carries an increased risk of drain occlusion, fistula formation, and paralytic ileus. Furthermore, one of the most critical aspects of appendectomy is the closure of the appendiceal stump, which can be achieved with the help of endoclips, sutures, staples, and endoloops. In this review, we discuss different aspects of management of acute appendicitis, current controversies in management, and the potential role of endoscopic appendectomy as a future treatment option.<\/jats:p>","DOI":"10.3390\/jcm13113034","type":"journal-article","created":{"date-parts":[[2024,5,22]],"date-time":"2024-05-22T07:56:11Z","timestamp":1716364571000},"page":"3034","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Controversies and Future Directions in Management of Acute Appendicitis: An Updated Comprehensive Review"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8544-9039","authenticated-orcid":false,"given":"Dushyant Singh","family":"Dahiya","sequence":"first","affiliation":[{"name":"Division of Gastroenterology, Hepatology & Motility, The University of Kansas School of Medicine, Kansas City, KS 66160, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamzah","family":"Akram","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hamilton Health Sciences, Hamilton, ON L8N 3Z5, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8062-5657","authenticated-orcid":false,"given":"Aman","family":"Goyal","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Seth GS Medical College and KEM Hospital, Mumbai 400012, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9796-8867","authenticated-orcid":false,"given":"Abdul Moiz","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Ayub Medical College, Abbottabad 22020, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syeda","family":"Shahnoor","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Dow University of Health Sciences, Karachi 74200, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6177-7575","authenticated-orcid":false,"given":"Khawaja M.","family":"Hassan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, King Edward Medical University, Lahore 54000, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manesh Kumar","family":"Gangwani","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5546-9197","authenticated-orcid":false,"given":"Hassam","family":"Ali","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Nutrition, East Carolina University\/Brody School of Medicine, Greenville, NC 27858, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bhanu Siva Mohan","family":"Pinnam","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, John H. Stroger, Jr. Hospital of Cook County, Chicago, IL 60612, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8776-2176","authenticated-orcid":false,"given":"Saqr","family":"Alsakarneh","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Missouri-Kansas City, Kansas City, MO 64110, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Canakis","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, University of Maryland School of Medicine, Baltimore, MD 21201, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0503-6961","authenticated-orcid":false,"given":"Abu Baker","family":"Sheikh","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of New Mexico, Albuquerque, NM 87131, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2661-6693","authenticated-orcid":false,"given":"Saurabh","family":"Chandan","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Creighton University School of Medicine, Omaha, NE 68178, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir Humza","family":"Sohail","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of New Mexico, Albuquerque, NM 87131, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,5,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e9","DOI":"10.1002\/bjs.9329","article-title":"Global disease burden of conditions requiring emergency surgery","volume":"101","author":"Stewart","year":"2013","journal-title":"Br. J. Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1007\/s00268-006-0056-y","article-title":"The Natural History and Traditional Management of Appendicitis Revisited: Spontaneous Resolution and Predominance of Prehospital Perforations Imply That a Correct Diagnosis is More Important Than an Early Diagnosis","volume":"31","author":"Andersson","year":"2007","journal-title":"World J. Surg."},{"key":"ref_3","first-page":"e40428","article-title":"Acute Appendicitis: Epidemiological, Clinical, Surgical, and Post-surgical Characteristics in a Honduran General Hospital","volume":"15","author":"Villeda","year":"2023","journal-title":"Cureus"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1002\/bjs.1800580916","article-title":"The aetiology of appendicitis","volume":"58","author":"Burkitt","year":"1971","journal-title":"Br. J. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1001\/archsurg.2010.328","article-title":"Effect of race and socioeconomic status in the treatment of appendicitis in patients with equal health care access","volume":"146","author":"Lee","year":"2011","journal-title":"Arch. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1007\/s00268-011-0988-8","article-title":"Changing incidence of acute appendicitis and nonspecific abdominal pain between 1987 and 2007 in Finland","volume":"35","author":"Ilves","year":"2011","journal-title":"World J. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1001\/jamasurg.2019.6030","article-title":"Geographic Association Between Incidence of Acute Appendicitis and Socioeconomic Status","volume":"155","author":"Golz","year":"2020","journal-title":"JAMA Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"3083","DOI":"10.1007\/s00268-017-4123-3","article-title":"Systematic Review and Meta-Analysis of Laparoscopic Versus Open Appendicectomy in Adults with Complicated Appendicitis: An Update of the Literature","volume":"41","author":"Athanasiou","year":"2017","journal-title":"World J. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2026","DOI":"10.1007\/s00268-010-0669-z","article-title":"Laparoscopic Versus Open Appendectomy in Adults with Complicated Appendicitis: Systematic Review and Meta-analysis","volume":"34","author":"Markides","year":"2010","journal-title":"World J. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1016\/j.jpedsurg.2018.10.064","article-title":"Gangrenous appendicitis: No longer complicated","volume":"54","author":"Nordin","year":"2019","journal-title":"J. Pediatr. Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s00068-022-02209-1","article-title":"Focus on identifying and closing knowledge gaps in acute appendicitis","volume":"49","author":"Kurihara","year":"2023","journal-title":"Eur. J. Trauma Emerg. Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1116","DOI":"10.1056\/NEJMcp2107675","article-title":"Treatment of acute uncomplicated appendicitis","volume":"385","author":"Talan","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1001\/jama.2020.10888","article-title":"Association of Nonoperative Management Using Antibiotic Therapy vs Laparoscopic Appendectomy with Treatment Success and Disability Days in Children with Uncomplicated Appendicitis","volume":"324","author":"Minneci","year":"2020","journal-title":"JAMA"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1007\/s00431-017-2867-2","article-title":"Conservative treatment in uncomplicated acute appendicitis: Reassessment of practice safety","volume":"176","author":"Steiner","year":"2017","journal-title":"Eur. J. Pediatr."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1097\/AOG.0b013e3181998424","article-title":"Medical management of ruptured appendicitis in pregnancy","volume":"114","author":"Young","year":"2009","journal-title":"Obstet. Gynecol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1467","DOI":"10.1016\/j.amjmed.2017.04.046","article-title":"Outcomes of Antibiotic Therapy for Uncomplicated Appendicitis in Pregnancy","volume":"130","author":"Joo","year":"2017","journal-title":"Am. J. Med."},{"key":"ref_17","first-page":"bcr2016214722","article-title":"Appendicitis during pregnancy in a Greenlandic Inuit woman; antibiotic treatment as a bridge-to-surgery in a remote area","volume":"2016","author":"Penninga","year":"2016","journal-title":"BMJ Case Rep."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1016\/j.surg.2020.04.019","article-title":"Geriatric patients undergoing appendectomy have increased risk of intraoperative perforation and\/or abscess","volume":"168","author":"Fan","year":"2020","journal-title":"Surgery"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Writing Group for the CODA Collaborative, Monsell, S.E., Voldal, E.C., Davidson, G.H., Fischkoff, K., Coleman, N., Bizzell, B., Price, T., Narayan, M., and Siparsky, N. (2022). Patient Factors Associated with Appendectomy within 30 Days of Initiating Antibiotic Treatment for Appendicitis. JAMA Surg., 157, e216900.","DOI":"10.1001\/jamasurg.2021.6900"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1033","DOI":"10.1007\/s00268-005-0304-6","article-title":"Appendectomy versus antibiotic treatment in acute appendicitis. A prospective multicenter randomized controlled trial","volume":"30","author":"Styrud","year":"2006","journal-title":"World J. Surg."},{"key":"ref_21","first-page":"459","article-title":"Comparison of operative and non operative management of acute appendicitis","volume":"15","author":"Turhan","year":"2009","journal-title":"Ulus. Travma Acil Cerrahi Derg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1002\/bjs.1800820207","article-title":"Randomized controlled trial of appendicectomy versus antibiotic therapy for acute appendicitis","volume":"82","author":"Eriksson","year":"1995","journal-title":"Br. J. Surg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2644","DOI":"10.1177\/00031348221114045","article-title":"Comparing Outcomes of Appendectomy Versus Non-operative Antibiotic Therapy for Acute Appendicitis: A Systematic Review and Meta-Analysis of Randomized Clinical Trials","volume":"89","author":"Zagales","year":"2023","journal-title":"Am. Surg."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1016\/j.surge.2017.02.001","article-title":"Antibiotics-first strategy for uncomplicated acute appendicitis in adults is associated with increased rates of peritonitis at surgery. A systematic review with meta-analysis of randomized controlled trials comparing appendectomy and non-operative management with antibiotics","volume":"15","author":"Podda","year":"2017","journal-title":"Surgeon"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1097\/SLA.0000000000000560","article-title":"The NOTA Study (Non Operative Treatment for Acute Appendicitis): Prospective study on the efficacy and safety of antibiotics (amoxicillin and clavulanic acid) for treating patients with right lower quadrant abdominal pain and long-term follow-up of conservatively treated suspected appendicitis","volume":"260","author":"Sibilio","year":"2014","journal-title":"Ann. Surg."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"CODA Collaborative, Davidson, G.H., Flum, D.R., Monsell, S.E., Kao, L.S., Voldal, E.C., Heagerty, P.J., Fannon, E., Lavallee, D.C., and Bizzell, B. (2021). Antibiotics versus Appendectomy for Acute Appendicitis\u2014Longer-Term Outcomes. N. Engl. J. Med., 385, 2395\u20132397.","DOI":"10.1056\/NEJMc2116018"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1001\/jama.2016.18719","article-title":"Surgical Decision Making: Challenging Dogma and Incorporating Patient Preferences","volume":"317","author":"Chhabra","year":"2017","journal-title":"JAMA"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"794","DOI":"10.1016\/j.amjsurg.2015.07.017","article-title":"Abscess due to perforated appendicitis: Factors associated with successful percutaneous drainage","volume":"212","author":"Fagenholz","year":"2016","journal-title":"Am. J. Surg."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1001\/jamasurg.2018.4374","article-title":"Settling the Controversy-Appendectomy as the Criterion for Appendicitis Diagnosis","volume":"154","author":"Kristo","year":"2019","journal-title":"JAMA Surg."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1177\/000313481207800344","article-title":"Increased risk of neoplasm in appendicitis treated with interval appendectomy: Single-institution experience and literature review","volume":"78","author":"Carpenter","year":"2012","journal-title":"Am. Surg."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1016\/j.amjsurg.2014.09.020","article-title":"Is there truly an oncologic indication for interval appendectomy?","volume":"209","author":"Wright","year":"2015","journal-title":"Am. J. Surg."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1001\/jamasurg.2018.4373","article-title":"Risk of Appendiceal Neoplasm in Periappendicular Abscess in Patients Treated with Interval Appendectomy vs Follow-up with Magnetic Resonance Imaging: 1-Year Outcomes of the Peri-Appendicitis Acuta Randomized Clinical Trial","volume":"154","author":"Rautio","year":"2019","journal-title":"JAMA Surg."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1177\/000313481608200107","article-title":"A Systematic Review of Perforated Appendicitis and Phlegmon: Interval Appendectomy or Wait-and-See?","volume":"82","author":"Darwazeh","year":"2016","journal-title":"Am. Surg."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/S1479-666X(07)80111-9","article-title":"Interval appendicectomy after resolution of adult inflammatory appendix mass\u2014Is it necessary?","volume":"5","author":"Deakin","year":"2007","journal-title":"Surgeon"},{"key":"ref_35","first-page":"107","article-title":"Perforating inflammation of the vermiform appendix, with special reference to its early diagnosis and treatment","volume":"1","author":"Fitz","year":"1886","journal-title":"Trans. Assoc. Am. Physicians"},{"key":"ref_36","first-page":"427","article-title":"Appendicitis: A historical review","volume":"24","author":"Seal","year":"1981","journal-title":"Can. J. Surg."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1016\/j.surg.2011.08.018","article-title":"Use of antibiotics alone for treatment of uncomplicated acute appendicitis: A systematic review and meta-analysis","volume":"150","author":"Liu","year":"2011","journal-title":"Surgery"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1573","DOI":"10.1016\/S0140-6736(11)60410-8","article-title":"Amoxicillin plus clavulanic acid versus appendicectomy for treatment of acute uncomplicated appendicitis: An open-label, non-inferiority, randomised controlled trial","volume":"377","author":"Vons","year":"2011","journal-title":"Lancet"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1097\/SLA.0000000000005996","article-title":"Delayed vs. Early Laparoscopic Appendectomy (DELAY) for Adult Patients with Acute Appendicitis: A randomized controlled trial","volume":"279","author":"Patel","year":"2023","journal-title":"Ann. Surg."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1001\/archsurg.141.5.504","article-title":"Effects of delaying appendectomy for acute appendicitis for 12 to 24 hours","volume":"141","author":"Bakhos","year":"2006","journal-title":"Arch. Surg."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1016\/j.amjsurg.2017.10.057","article-title":"Early versus delayed appendectomy: A comparison of outcomes","volume":"215","author":"Seudeal","year":"2018","journal-title":"Am. J. Surg."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"897","DOI":"10.1177\/000313481207800827","article-title":"Delaying an appendectomy: Is it safe?","volume":"78","author":"Nagpal","year":"2012","journal-title":"Am. Surg."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1186\/1749-7922-9-8","article-title":"Delayed appendectomy versus early appendectomy in the treatment of acute appendicitis: A retrospective study","volume":"9","author":"Shin","year":"2014","journal-title":"World J. Emerg. Surg."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"933","DOI":"10.1002\/bjs.10873","article-title":"Meta-analysis of in-hospital delay before surgery as a risk factor for complications in patients with acute appendicitis","volume":"105","author":"Dijkgraaf","year":"2018","journal-title":"Br. J. Surg."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1097\/01.sla.0000231726.53487.dd","article-title":"Is it safe to delay appendectomy in adults with acute appendicitis?","volume":"244","author":"Ditillo","year":"2006","journal-title":"Ann. Surg."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1856","DOI":"10.1007\/s11605-018-3911-x","article-title":"CT Scan Findings Can Predict the Safety of Delayed Appendectomy for Acute Appendicitis","volume":"23","author":"Jeon","year":"2019","journal-title":"J. Gastrointest. Surg."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1016\/j.jss.2020.03.038","article-title":"Operative Delay in Adults with Appendicitis: Time is Money","volume":"253","author":"Aiken","year":"2020","journal-title":"J. Surg. Res."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"350","DOI":"10.53350\/pjmhs22169350","article-title":"Antibiotics Versus Appendectomy for Acute Appendicitis","volume":"16","author":"Ali","year":"2022","journal-title":"Pak. J. Med. Health Sci."},{"key":"ref_49","first-page":"52","article-title":"The Role of Prophylactic Antibiotics in Prevention of Wound Infections in Open Appendectomy Patients in Al-Diwaniayh Teaching Hospital","volume":"4","author":"Alammar","year":"2023","journal-title":"J. Asian Multicult. Res. Med. Health Sci. Study"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1901","DOI":"10.3126\/bjhs.v7i3.52768","article-title":"Effectiveness of Use of Single Dose Preoperative Antibiotic versus both Pre and Post Operative Antibiotics in Patients Undergoing Laparoscopic Uncomplicated Appendectomy in Birat Medical College Teaching Hospital (BMCTH)","volume":"7","author":"Shrestha","year":"2022","journal-title":"Birat J. Health Sci."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1186\/s13017-020-00306-3","article-title":"Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines","volume":"15","author":"Podda","year":"2020","journal-title":"World J. Emerg. Surg."},{"key":"ref_52","first-page":"177","article-title":"A trial of various regimens of antibiotics in acute appendicitis","volume":"18","author":"Kumarakrishnan","year":"1997","journal-title":"Trop Gastroenterol."},{"key":"ref_53","first-page":"481","article-title":"Factors influencing antibiotic prophylaxis for surgical site infection prevention in general surgery: A review of the literature","volume":"52","author":"Gagliardi","year":"2009","journal-title":"Can. J. Surg."},{"key":"ref_54","first-page":"162","article-title":"Postoperative Antibiotics and Time to Reach Discharge Criteria after Appendectomy for Complex Appendicitis","volume":"39","author":"Giesen","year":"2023","journal-title":"Dig. Surg."},{"key":"ref_55","first-page":"104","article-title":"Postoperative antibiotic therapy after appendectomy in patients with non-perforated appendicitis","volume":"8","author":"Nikbakhsh","year":"2017","journal-title":"Casp. J. Intern. Med."},{"key":"ref_56","first-page":"54","article-title":"Peculiarities of course of operational and postoperative periods in appendectomy after various methods of the antibiotics introduction","volume":"89","author":"Duzhyi","year":"2022","journal-title":"Ukr. J. Clin. Surg."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1136\/bmj.333.7569.652-b","article-title":"Acute appendicitis: Weighing up risks and benefits of investigations and treatments","volume":"333","author":"Purkayastha","year":"2006","journal-title":"BMJ"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1016\/j.amsu.2018.10.040","article-title":"Is abdominal drainage after open emergency appendectomy for complicated appendicitis beneficial or waste of money? A single centre retrospective cohort study","volume":"36","author":"Abdulhamid","year":"2018","journal-title":"Ann. Med. Surg."},{"key":"ref_59","first-page":"180","article-title":"Use of drains in surgery: A review","volume":"19","author":"Durai","year":"2009","journal-title":"J. Perioper. Pract."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1186\/s13017-018-0179-0","article-title":"Prospective Observational Study on acute Appendicitis Worldwide (POSAW)","volume":"13","author":"Sartelli","year":"2018","journal-title":"World J. Emerg. Surg."},{"key":"ref_61","first-page":"1048","article-title":"An experimental study of the local effects of peritoneal drainage","volume":"21","author":"Yates","year":"1955","journal-title":"Am. Surg."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1007\/s00423-010-0709-z","article-title":"Prevention of infectious complications after laparoscopic appendectomy for complicated acute appendicitis--the role of routine abdominal drainage","volume":"396","author":"Allemann","year":"2011","journal-title":"Langenbecks Arch. Surg."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1007\/s00383-003-1029-y","article-title":"The utility of peritoneal drains in children with uncomplicated perforated appendicitis","volume":"19","author":"Tander","year":"2003","journal-title":"Pediatr. Surg. Int."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"282","DOI":"10.12968\/hosp.2002.63.5.2021","article-title":"The uses and abuses of drains in abdominal surgery","volume":"63","author":"Memon","year":"2002","journal-title":"Hosp. Med."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"1074","DOI":"10.1097\/01.sla.0000146149.17411.c5","article-title":"Evidence-based value of prophylactic drainage in gastrointestinal surgery: A systematic review and meta-analyses","volume":"240","author":"Petrowsky","year":"2004","journal-title":"Ann. Surg."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1177\/1553350617753244","article-title":"Irrigation Versus Suction Alone in Laparoscopic Appendectomy: Is Dilution the Solution to Pollution? A Systematic Review and Meta-Analysis","volume":"25","author":"Hajibandeh","year":"2018","journal-title":"Surg. Innov."},{"key":"ref_67","first-page":"CD010168","article-title":"Abdominal drainage to prevent intra-peritoneal abscess after open appendectomy for complicated appendicitis","volume":"2","author":"Cheng","year":"2015","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_68","first-page":"e32018","article-title":"Evaluation of Drain Insertion After Appendicectomy for Complicated Appendicitis: A Systematic Review and Meta-Analysis","volume":"14","author":"Abu","year":"2022","journal-title":"Cureus"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"4668","DOI":"10.1007\/s00464-016-5245-7","article-title":"Diagnosis and management of acute appendicitis. EAES consensus development conference 2015","volume":"30","author":"Gorter","year":"2016","journal-title":"Surg. Endosc."},{"key":"ref_70","first-page":"CD006437","article-title":"Closure methods of the appendix stump for complications during laparoscopic appendectomy","volume":"11","author":"Mannu","year":"2017","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_71","doi-asserted-by":"crossref","unstructured":"Marcinkeviciute, K., Luksaite-Lukste, R., Jasiunas, E., and Poskus, T. (2023). Self-Locking Polymeric Clips Are Safe for the Closure of Appendiceal Stump in Laparoscopic Appendectomy. Medicina, 59.","DOI":"10.3390\/medicina59030533"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1089\/lap.2011.0348","article-title":"The Use of a Single Hem-o-lok Clip in Securing the Base of the Appendix During Laparoscopic Appendectomy","volume":"22","year":"2012","journal-title":"J. Laparoendosc. Adv. Surg. Tech."},{"key":"ref_73","first-page":"59","article-title":"Laparoscopic appendectomy using a polymeric clip to close the appendicular stump","volume":"11","author":"Hanssen","year":"2007","journal-title":"JSLS"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1007\/s00423-011-0869-5","article-title":"Appendix stump closure with titanium clips in laparoscopic appendectomy","volume":"397","author":"Rickert","year":"2012","journal-title":"Langenbecks Arch. Surg."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1089\/lap.2016.0433","article-title":"A Comparison of Endoloop Ligatures and Nonabsorbable Polymeric Clips for the Closure of the Appendicular Stump During Laparoscopic Appendectomy in Children","volume":"27","author":"Kostovski","year":"2017","journal-title":"J. Laparoendosc. Adv. Surg. Tech."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1186\/1749-7922-8-35","article-title":"Appendiceal stump closure by metal endoclip in the management of complicated acute appendicitis","volume":"8","author":"Gomes","year":"2013","journal-title":"World J. Emerg. Surg."},{"key":"ref_77","first-page":"85","article-title":"Comparison Among Different Closure Methods of the Appendicular Stump in Laparoscopic Appendectomy","volume":"21","author":"Partecke","year":"2011","journal-title":"Surg. Technol. Int."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"0300060519856154","DOI":"10.1177\/0300060519856154","article-title":"Appendiceal stump closure with polymeric clips is a reliable alternative to endostaplers","volume":"48","author":"Soll","year":"2020","journal-title":"J. Int. Med. Res."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1089\/lap.2014.0470","article-title":"Management of appendiceal stump in laparoscopic appendectomy--clips or ligature: A systematic review and meta-analysis","volume":"25","author":"Shaikh","year":"2015","journal-title":"J. Laparoendosc. Adv. Surg. Tech. A"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"152","DOI":"10.5114\/wiitm.2014.41624","article-title":"Laparoscopic appendectomy with hand-made loop","volume":"9","author":"Mayir","year":"2014","journal-title":"Videosurgery Other Miniinvasive Tech."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1097\/SLE.0b013e31824f25cd","article-title":"Comparison of intracorporeal knot-tying suture (polyglactin) and titanium endoclips in laparoscopic appendiceal stump closure: A prospective randomized study","volume":"22","author":"Ates","year":"2012","journal-title":"Surg. Laparosc. Endosc. Percutaneous Tech."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1016\/j.bpg.2013.11.016","article-title":"Laparoscopic appendectomy: State of the art. Tailored approach to the application of laparoscopic appendectomy?","volume":"28","author":"Gorter","year":"2014","journal-title":"Best Pract. Res. Clin. Gastroenterol."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1016\/j.jpedsurg.2017.05.016","article-title":"Looped suture versus stapler device in pediatric laparoscopic appendectomy: A comparative outcomes and intraoperative cost analysis","volume":"53","author":"Parikh","year":"2018","journal-title":"J. Pediatr. Surg."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"22","DOI":"10.21037\/ales.2018.03.04","article-title":"Laparoscopic appendectomy: Comparison between different techniques for the closure of the appendicular stump","volume":"3","author":"Frattini","year":"2018","journal-title":"Ann. Laparosc. Endosc. Surg."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"2295","DOI":"10.1007\/s00464-017-5924-z","article-title":"The influence of the different forms of appendix base closure on patient outcome in laparoscopic appendectomy: A randomized trial","volume":"32","author":"Mehmedovic","year":"2018","journal-title":"Surg. Endosc."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"69","DOI":"10.5114\/wiitm.2011.31535","article-title":"Analysis of intracorporeal knotting with invaginating suture versus endoloops in appendiceal stump closure","volume":"8","author":"Kiudelis","year":"2013","journal-title":"Videosurgery Other Miniinvasive Tech."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1016\/j.amsu.2020.07.058","article-title":"Closure of the appendiceal stump in laparoscopic appendectomy: A systematic review of the literature","volume":"57","author":"Makaram","year":"2020","journal-title":"Ann. Med. Surg."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"409","DOI":"10.3393\/ac.2020.00437.0062","article-title":"Conversion rate and risk factors of conversion to open in laparoscopic appendicectomy","volume":"38","author":"Pushpanathan","year":"2022","journal-title":"Ann. Coloproctol."},{"key":"ref_89","first-page":"397","article-title":"Infectious complications following laparoscopic appendectomy","volume":"49","author":"Gupta","year":"2006","journal-title":"Can. J. Surg."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"1248","DOI":"10.1016\/j.gie.2015.11.014","article-title":"Endoscopic resection is cost-effective compared with laparoscopic resection in the management of complex colon polyps: An economic analysis","volume":"83","author":"Law","year":"2016","journal-title":"Gastrointest. Endosc."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1016\/j.gie.2017.07.015","article-title":"Endoscopic transcecal appendectomy: The first human case report","volume":"87","author":"Liu","year":"2018","journal-title":"Gastrointest. Endosc."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1055\/a-1675-2625","article-title":"Endoscopic transcecal appendectomy: A new endotherapy for appendiceal orifice lesions","volume":"54","author":"Guo","year":"2022","journal-title":"Endoscopy"},{"key":"ref_93","first-page":"e40827","article-title":"Endoscopic Transcecal Appendectomy (ETA): A Literature Review on Risks and Benefits","volume":"15","author":"Nduma","year":"2023","journal-title":"Cureus"},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"1812","DOI":"10.1136\/gutjnl-2020-323018","article-title":"Transcolonic endoscopic appendectomy: A novel natural orifice transluminal endoscopic surgery (NOTES) technique for the sessile serrated lesions involving the appendiceal orifice","volume":"70","author":"Chen","year":"2021","journal-title":"Gut"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/11\/3034\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:46:14Z","timestamp":1760107574000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/11\/3034"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,22]]},"references-count":94,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2024,6]]}},"alternative-id":["jcm13113034"],"URL":"https:\/\/doi.org\/10.3390\/jcm13113034","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,22]]}}}