Efetividade do manejo conservador da apendicite aguda não complicada em comparação a apendicectomia de urgência: uma revisão sistemática rápida

Abstract

Introduction: Currently, an increasing amount of scientific evidence has shown that perforation is not an inevitable evolution of appendiceal obstruction. Thus, in the last 20 years, there has been an increase in the scientific production of studies demonstrating the safety of the non-operative treatment of Acute Appendicitis (AA) with the use of antibiotics. Method: This is a rapid systematic literature review, the studies were extracted from the PubMed databases of the National Library of Medicine, EMBASE, SCIELO and the Virtual Health Library (BVS). Only randomized clinical trials that compared conservative treatment with antibiotics with urgent surgical treatment in adults aged 18 years and older with uncomplicated acute appendicitis were included. Result: In this meta-analysis, an effectiveness of 83.8% (95% CI: 87.99% - 78.17%) was found for surgical treatment and for the conservative management of uncomplicated AA, an overall effective rate of 68.77% in this study. (95%CI: 65.20% - 72.53%) and 75.20% (95%CI: 71.50% - 79.09%) after sensitivity analysis with exclusion of articles with high risk of bias. Conclusion: Conservative treatment with antibiotics is safe and associated with lower risks of complications, but it is significantly less effective than treatment with appendectomy in adults with uncomplicated AA and without appendicitis.