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EVALUATING THE OUTCOMES OF ANTIBIOTIC TREATMENT VERSUS LAPAROSCOPIC APPENDECTOMY FOR ACUTE UNCOMPLICATED APPENDICITIS
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Abstract
Background: Recent studies suggest that antibiotic treatment for uncomplicated acute appendicitis may be an effective alternative to surgery, with comparable outcomes. Objective: To evaluate the outcomes of antibiotic therapy compared to laparoscopic appendectomy in the treatment of acute appendicitis. Subjects and Methods: This was an open-label, randomized controlled, non-inferiority clinical trial involving 311 patients diagnosed with acute appendicitis at Can Tho University of Medicine and Pharmacy Hospital from May 2022 to February 2025. Among them, 151 patients received antibiotic treatment, while 160 underwent laparoscopic surgery. Results: The 30-day peritonitis rate showed no significant difference between the antibiotic group (1.99%) and the surgical group (1.88%), with a difference of 0.11% (95% CI: -3.17 to 2.95). The antibiotic group had a shorter sick leave duration (4.52 ± 1.13 days vs. 6.57 ± 1.09 days; p < 0.001). Although the overall complication rate was higher in the antibiotic group (7.5% vs. 3.31%; p = 0.134), the 1-year success rate was also higher (93.13% vs. 83.44%; p = 0.018). However, 17.21% of patients in the antibiotic group experienced recurrence within one year. No deaths were reported during the follow-up period. Conclusion: Most cases of uncomplicated acute appendicitis can be successfully treated with antibiotics, showing lower morbidity and faster recovery compared to surgery. Nevertheless, the results are not sufficient to confirm non-inferiority of antibiotic therapy over appendectomy within a one-year follow-up period.
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Keywords
Conservative treatment, appendectomy, antibiotics
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