SynthesisLangenbeck's archives of surgery2021
Early versus delayed (interval) appendicectomy for the management of appendicular abscess and phlegmon: a systematic review and meta-analysis.
Synthesis in Langenbeck's archives of surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.
- Early versus delayed laparoscopic appendectomy for acute uncomplicated appendicitis in adults: a systematic review and meta-analysis.BMC surgery · 2025Pooled it
- Interval Appendicectomy after Conservative Management of Complicated Appendicitis: Balancing Recurrence, Neoplasm Risk, and Surveillance Strategies.Digestive surgery · 2026Review
- Ultrasound-Guided Percutaneous Catheter Drainage in Periappendiceal abscess Management: Retrospective Insights.Pakistan journal of medical sciences · 2025Article
- Three reasons to consider interval appendectomy for the management of complicated appendicitis.Updates in surgery · 2024Article
- Early versus delayed appendicectomy for appendiceal phlegmon or abscess.The Cochrane database of systematic reviews · 2024Review
- Problematic meta-analyses: Bayesian and frequentist perspectives on combining randomized controlled trials and non-randomized studies.BMC medical research methodology · 2024Article
- Endoscopic retrograde appendicitis therapy for giant periappendiceal abscess with intestinal obstruction.Endoscopy · 2023Article
- Subacute Appendicular Abscess Masquerading as Neoplasia Causing Large Bowel Obstruction.ACG case reports journal · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThe safety and role of emergency (EA) versus interval appendicectomy (IA) for appendicular abscess and phlegmon remains debatable with no optimal strategy identified. The aim of this systematic review and meta-analysis is to evaluate outcomes of managing appendicular abscesses and phlegmon with emergency or interval appendicectomy.
methodsWe conducted a systematic search of electronic databases using key terms including 'appendicular abscess', 'appendicular phlegmon' and 'interval appendicectomy'. Randomised controlled trials and observational studies comparing the two management approaches were included. Operative time, post-operation complication, unplanned bowel resection, rate of surgical site infection, post-operative length of stay and overall mortality rate were evaluated.
resultsWe identified six studies (2 RCTs and 4 observational studies) with a total of 9264 patients of whom (n = 1352) underwent IA, and (n 7912) underwent EA. The EA group was associated with statistically significant unplanned bowel resection (OR 0.55, 95% CI [0.33-0.90], P = 0.02) and longer total operating time (MD - 14.11, 95% CI [- 18.26-- 9.96] P = 0.00001). However, the following parameters were compared for both EA and IA groups; there were no significant statistical differences: surgical site infection (OR 0.49, 95% CI [0.17-1.38], P = 0.18), post-operative intra-abdominal collection (RD - 0.01, 95% CI [- 0.04-0.01], P = 0.29), total length of hospital stay (MD 1.83, 95% CI [- 0.19-3.85], P = 0.08), post-operative length of hospital stay (MD - 0.27, 95% CI [- 3.66-3.13], P = 0.88) and mortality rate (MD - 0.27, 95% CI [- 3.66-3.13], P = 0.66).
conclusionEmergency operation for appendicular abscess and phlegmon may lead to a higher rate of reported morbidity when compared with interval appendicectomy. Although emergency appendicectomy performed for appendicular abscess and phlegmon is a feasible and safe operative approach, it is associated with significantly increased operative time and unplanned bowel resection (ileocolic and right hemicolectomies) compared to interval appendicectomy.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.