Evaluating Management Strategies for Appendicular Mass: A Systematic Review and Meta-Analysis of Conservative Versus Surgical Approaches

Background: Acute appendicitis is a frequent emergent situation that necessitates surgery. Complications, including an appendiceal mass, occur in 2-10% of appendicitis cases. Management of appendicular mass remains controversial, from non-operative to operative. Aim and Objective: This meta-analysis and systematic review were intended to determine how well conservative management could match up against early appendicular mass. One of the questions underlying this research was: “Can conservative management offer the same results as surgery with fewer complications and hospitalization?”. Methods: Electronic databases such as PubMed, Embase, and Scopus were searched from 2015-2024 and 1378 studies were retrieved. Thirteen studies were finally included. Results: The overall success rate with conservative management was 90% (95% CI: 87-94) and complications were at a rate of 10% (95% CI: 8-11). However, the complication rate with the surgical approach was 19% (95% CI: 15-22). The recurrence rates for conservative management were 9% (95% CI: 1-17). Conclusion: Conservative treatment of appendicular mass is effective and less complex than early appendectomy indicating that it may be a viable first line of treatment. Standard treatment protocols will need to be established through further high-quality studies.