CONSERVATIVE TREATMENT OF ACUTE APPENDICITIS VERSUS EMERGENCY APPENDECTOMY: A RAPID SYSTEMATIC REVIEW

Introduction: Currently, increasing scientific evidence suggests that perforation is not an inevitable outcome of appendiceal obstruction. Over the past 25 years, the scientific literature has increasingly demonstrated the safety of non-operative treatment of Acute Appendicitis (AA) with antibiotics. Method: This study is a rapid systematic literature review. Studies were extracted from the PubMed databases of the National Library of Medicine, EMBASE, SCIELO, and the Virtual Health Library (VHL). Only randomized controlled clinical trials comparing conservative treatment with antibiotics to urgent surgical treatment in adults over 18 years old with uncomplicated acute appendicitis were included. Results: This meta-analysis found an effectiveness of 83.8% (95% CI: 87.99% - 78.17%) for surgical treatment and a global effectiveness rate of 68.77% (95% CI: 65.20% - 72.53%) for the conservative management of uncomplicated AA, increasing to 75.20% (95% CI: 71.50% - 79.09%) after sensitivity analysis excluding articles with a high risk of bias. Conclusion: Conservative treatment with antibiotics is safe and associated with lower risks of complications; however, it is significantly less effective than appendectomy in adults with uncomplicated AA without appendicolith.