Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
The Academy of Medical Science, Zhengzhou University, Zhengzhou, China.
Expert Rev Gastroenterol Hepatol. 2021 Jun;15(6):657-664. doi: 10.1080/17474124.2021.1868298. Epub 2021 Jan 4.
Appendectomy remains the gold standard for treating uncomplicated and complicated appendicitis. However, the vermiform appendix may play a significant role in the immune system (secondary immune function) and maintain a reservoir of the normal microbiome for the human body. The aim of this study was to summarize the long-term effects after appendectomy and discuss whether appendectomy is suitable for all appendicitis patients.
A comprehensive and unbiased literature search was performed in PubMed. The terms 'appendix,' 'appendicitis,' 'appendectomy,' and 'endoscopic retrograde appendicitis therapy' were searched in the title and/or abstract. This review summarizes the long-term effects of appendectomy on some diseases in humans and describes three methods including appendectomy, medical treatment, and an 'organ-sparing' technique, named endoscopic retrograde appendicitis therapy (ERAT) to treat appendicitis.
Appendectomy remains the first-line therapy for appendicitis. The patient's problem is appendix, not appendicitis. If we treat appendicitis, the problem should be resolved. During COVID-19, an initial antibiotic treatment of mild appendicitis represents a promising strategy. For patients who are worried about the long-term adverse effect after appendectomy and have a strong desire to preserve the appendix and are aware of the risk of appendicitis recurrence, medical treatment, or ERAT could be proposed.
阑尾切除术仍然是治疗单纯性和复杂性阑尾炎的金标准。然而，阑尾在免疫系统（二级免疫功能）中可能发挥重要作用，并为人体维持正常微生物组的储库。本研究旨在总结阑尾切除术后的长期影响，并讨论阑尾切除术是否适用于所有阑尾炎患者。
在 PubMed 上进行了全面和公正的文献检索。在标题和/或摘要中搜索了“阑尾”、“阑尾炎”、“阑尾切除术”和“内镜逆行阑尾炎治疗”等术语。本综述总结了阑尾切除术对人类某些疾病的长期影响，并描述了三种方法，包括阑尾切除术、药物治疗和一种名为内镜逆行阑尾炎治疗（ERAT）的“保留器官”技术，用于治疗阑尾炎。
阑尾切除术仍然是阑尾炎的首选治疗方法。患者的问题是阑尾，而不是阑尾炎。如果我们治疗阑尾炎，问题应该得到解决。在 COVID-19 期间，轻度阑尾炎的初始抗生素治疗代表了一种有前途的策略。对于那些担心阑尾切除术后长期不良影响且强烈希望保留阑尾并意识到阑尾炎复发风险的患者，可以提出药物治疗或 ERAT。
