World J Gastroenterol. 2011 Jul 7;17(25):2977-80. doi: 10.3748/wjg.v17.i25.2977.
The need for interval appendicectomy (I.A) after successful conservative management of appendiceal mass has recently been questioned. Furthermore, emergency appendicectomy for appendiceal mass is increasingly performed with equal success and safety to that performed in non-mass forming acute appendicitis. There is an increasing volume of evidence -although mostly retrospective- that if traditional conservative management is adopted, there is no need for routine I.A except for a small number of patients who continue to develop recurrent symptoms. On the other hand, the routine adoption of emergency laparoscopic appendicectomy (LA) in patients presenting with appendiceal mass obviates the need for a second admission and an operation for I.A with a considerable complication rate. It also abolishes misdiagnoses and deals promptly with any unexpected ileo-cecal pathology. Moreover, it may prove to be more cost-effective than conservative treatment even without I.A due to a much shorter hospital stay and a shorter period of intravenous antibiotic administration. If emergency LA is to become the standard of care for appendiceal mass, I.A will certainly become 'something' of the past.
经保守治疗成功的阑尾包块是否需要再次行间隔期阑尾切除术（I.A），这一问题近来受到质疑。此外，与非肿块形成性急性阑尾炎相比，急诊阑尾切除术治疗阑尾包块的成功率和安全性相当，且已得到越来越多的证据支持，尽管这些证据大多为回顾性的。如果采用传统的保守治疗方法，除了一小部分持续出现反复发作症状的患者外，通常无需常规进行 I.A。另一方面，对于以阑尾包块为表现的患者，常规采用急诊腹腔镜阑尾切除术（LA），可以避免再次住院和行 I.A 手术，而且并发症发生率也相当可观。此外，它还可以避免误诊，并及时处理任何意外的回盲部病变。此外，由于住院时间和静脉用抗生素治疗时间更短，即使不进行 I.A，急诊 LA 也可能比保守治疗更具成本效益。如果急诊 LA 成为阑尾包块的治疗标准，那么 I.A 肯定会成为过去式。
