Editing Appendectomy (section)

{{short description|Surgical removal of the vermiform appendix}}
{{Infobox medical intervention (new)
| name          = Appendectomy
| synonyms      = Appendisectomy, appendicectomy
| image         = Blinddarm-01.jpg
| caption       = An appendectomy in progress
| pronounce     =
| specialty     = [[General surgery]]
| uses          = [[Appendicitis]]
| complications = Infection, bleeding
| approach      = [[Laparoscopic]], open
| types         =
| recovery = 1-3 weeks
| outcomes      =
| frequency     =Common
| cost          =
}}

An '''appendectomy''' ([[American English]]) or '''appendicectomy''' ([[British English]]) is a [[Surgery|surgical operation]] in which the [[vermiform appendix]] (a portion of the intestine) is removed. Appendectomy is normally performed as an urgent or emergency procedure to treat complicated acute [[appendicitis]].<ref name=":3">{{Cite book|title=Surgical Recall|last=Backbourne|first=Lorne|publisher=Wolters Kluwer|pages=198–203}}</ref>

Appendectomy may be performed [[Laparoscopic surgery|laparoscopically]] (as [[minimally invasive surgery]]) or as an open operation.<ref name=":0" /> Over the 2010s, surgical practice has increasingly moved towards routinely offering laparoscopic appendicectomy; for example in the [[United Kingdom]] over 95% of adult appendicectomies are planned as laparoscopic procedures.<ref>{{cite journal |last1=RIFT Study Group on behalf of the West Midlands Research Collaborative |title=Evaluation of appendicitis risk prediction models in adults with suspected appendicitis |journal=British Journal of Surgery |date=3 December 2019 |volume=107 |issue=1 |pages=73–86 |doi=10.1002/bjs.11440 |pmid=31797357 |pmc=6972511 |language=en |issn=1365-2168}}</ref> Laparoscopy is often used if the diagnosis is in doubt, or in order to leave a less visible surgical scar. Recovery may be slightly faster after laparoscopic surgery, although the laparoscopic procedure itself is more expensive and resource-intensive than open surgery and generally takes longer. Advanced pelvic sepsis occasionally requires a lower midline [[laparotomy]].

Complicated (perforated) appendicitis should undergo prompt surgical intervention.<ref name=":3" />  There has been significant recent trial evidence that uncomplicated appendicitis can be treated with either antibiotics or appendicectomy,<ref name="antibiotics">{{cite journal |last1=Javanmard-Emamghissi |first1=Hannah |title=Antibiotics as first-line alternative to appendicectomy in adult appendicitis: 90-day follow-up from a prospective, multicentre cohort study |journal=The British Journal of Surgery |date=Sep 3, 2021 |volume=108 |issue=11 |pages=1351–1359 |doi=10.1093/bjs/znab287 |pmid=34476484 |pmc=8499866 |url=https://academic.oup.com/bjs/advance-article/doi/10.1093/bjs/znab287/6363089?searchresult=1 |access-date=8 September 2021 |archive-date=8 September 2021 |archive-url=https://web.archive.org/web/20210908083444/https://academic.oup.com/bjs/advance-article/doi/10.1093/bjs/znab287/6363089?searchresult=1 |url-status=live }}</ref><ref>{{cite journal |last1=CODA Collaborative |title=A Randomized Trial Comparing Antibiotics with Appendectomy for Appendicitis. |journal=The New England Journal of Medicine |date=Oct 5, 2020 |volume=20 |issue=383 |pages=1907–1919 |doi=10.1056/NEJMoa2014320 |pmid=33017106|s2cid=222151141 |doi-access=free }}</ref> with 51% of those treated with antibiotics avoiding an appendectomy after 3 years.<ref>{{Cite web |date=2024-05-06 |title=Comparing Surgery versus Antibiotics for Treating Adults with Uncomplicated Appendicitis - Evidence Update for Clinicians {{!}} PCORI |url=https://www.pcori.org/evidence-updates/comparing-surgery-versus-antibiotics-treating-adults-uncomplicated-appendicitis |access-date=2024-05-25 |website=www.pcori.org |language=en}}</ref> After appendicectomy the main difference in treatment is the length of time the antibiotics are administered. For uncomplicated appendicitis, antibiotics should be continued up to 24 hours post-operatively. For complicated appendicitis, antibiotics should be continued for anywhere between 3 and 7 days.<ref name=":3" /> An interval appendectomy is generally performed 6–8 weeks after conservative management with antibiotics for special cases, such as perforated appendicitis.<ref>[https://jomi.com/article/270/Laparoscopic-Appendectomy-and-Open-Umbilical-Hernia-Repair] {{Webarchive|url=https://web.archive.org/web/20201013014156/https://jomi.com/article/270/Laparoscopic-Appendectomy-and-Open-Umbilical-Hernia-Repair|date=2020-10-13}}, Sell N, O'Donnell T, Saillant N. Laparoscopic Appendectomy and Open Umbilical Hernia Repair. J Med Ins. 2019;2019(270) doi:https://jomi.com/article/270 {{Webarchive|url=https://web.archive.org/web/20220618003211/https://jomi.com/article/270|date=2022-06-18}}</ref> Delay of appendectomy 24 hours after admission for symptoms of appendicitis has not been shown to increase the risk of perforation or other complications.<ref name=":4" />