Risk of appendicitis after endoscopic full-thickness resection of lesions involving the appendiceal orifice: a retrospective analysis

Endoscopy. 2021 Apr;53(4):424-428. doi: 10.1055/a-1227-4555. Epub 2020 Sep 7.

Abstract

Background: Conventional endoscopic resection of lesions affecting the appendiceal orifice is difficult. Endoscopic full-thickness resection (EFTR) is a novel technique in interventional endoscopy. As EFTR near the appendiceal orifice is associated with a subtotal appendectomy, it remains unclear whether the risk of developing appendicitis is increased. We conducted a retrospective analysis of lesions involving the appendiceal orifice treated by EFTR.

Methods: This was a multicenter retrospective analysis of patients (n = 50) treated with EFTR for lesions involving the appendiceal orifice between 2014 and 2019. The objective was to evaluate the occurrence of appendicitis.

Results: Acute appendicitis occurred in seven patients (14 %) during follow-up. Conservative treatment was sufficient in four cases, and three patients underwent appendectomy.

Conclusions: EFTR of lesions involving the appendiceal orifice may be associated with an imminent risk of developing appendicitis and a consecutive need for appendectomy. Patients should be informed about this specific risk prior to resection. It is unclear why some patients develop appendicitis while the majority remains asymptomatic.

Publication types

  • Multicenter Study

MeSH terms

  • Appendicitis* / etiology
  • Appendicitis* / surgery
  • Appendix* / diagnostic imaging
  • Appendix* / surgery
  • Endoscopic Mucosal Resection*
  • Endoscopy
  • Humans
  • Retrospective Studies