Factors Associated With Extended Resection (Cecal Resection or Right Hemicolectomy) in Patients With Acute Appendicitis at a Tertiary Private Hospital: A Retrospective Cohort Study

INTRODUCTION: Acute appendicitis may require surgical procedures beyond conventional appendectomy, including cecal resection and right hemicolectomy. This study aimed to identify clinical factors associated with extended resection in adults undergoing surgery for acute appendicitis. METHODS: This retrospective, single-center cohort study included 360 adults treated surgically for acute appendicitis at a tertiary care hospital between 2018 and 2023. Extended resection was defined as cecal resection or right hemicolectomy. Associations were assessed using univariate analyses and multivariable logistic regression adjusted for age, symptom duration, previous abdominal surgery, diabetes mellitus, and hypertension. Appendicitis severity was evaluated in a secondary model using grouped phases. Missing data were not imputed. The study received ethics committee approval (2024-EXT-871). RESULTS: Extended resection occurred in 50 of 351 patients with available outcome data (14.2%). Longer symptom duration (adjusted odds ratio (aOR) 1.185; 95% confidence interval (CI) 1.004-1.398; p=0.045) and older age (aOR 1.022; 95% CI 1.001-1.045; p=0.045) were associated with extended resection in the primary model. In the secondary model, advanced appendicitis phases were strongly associated with extended resection (aOR 10.273; 95% CI 4.694-22.481; p<0.001). CONCLUSION: Longer symptom duration was associated with extended resection, including after adjustment for grouped appendicitis severity. These findings warrant cautious interpretation given the retrospective design and limited number of events.