Efficacy And Safety Of Appendicectomy Versus Antibiotics For Uncomplicated Acute Appendicitis: A Meta-analysis

[Objective] To systematically review the effectiveness of appendicectomy and antibiotics for uncomplicated acute appendicitis(UCAA).[Methods] Following the principle of evidence-based medicine.Using “Acute appendicitis”、“Anti-bacterial agents”、“Appendicectomy”、“Meta-analysis”、“Randomized controlled trial” as key words,Databases covering PubMed,EMbase,The Cochrane Library(Issue 8,2016),Web of Science,CBM,WanFang Data and CNKI were searched to collect randomized controlled trials(RCTs)about appendicectomy and antibiotics for uncomplicated acute appendicitis,retrieve the update of the existing literature until September 2016.Meta-analysis was performed using RevMan 5.3 software after independently reviewing the literature by two reviewers,extracting data and evaluating the risk of bias into the study.[Results] A total of 10 RCTs studies involving 2 028 patients were included.The results of meta-analysis showed that,compared with antibiotics,the appendicectomy could shorten duration of hospital stay(MD=–1.89,95%CI –2.75 to –1.04,P<0.000 01),the therapeutic time of antibiotics(MD=–4.42,95%CI –5.06 to –3.79,P<0.000 01),improve the efficiency of clinical treatment(OR=23.48,95%CI 7.99 to 68.96,P<0.00001),decrease the recurrence rate(OR=0.02,95%CI 0.01 to 0.05,P<0.000 01),however,there was no significant difference in the incidence of postoperative complications between two groups(OR=1.35,95%CI 0.31 to 5.87,P=0.69).[Conclusions] The current evidence shows that,compared with antibiotics,the appendicectomy for uncomplicated acute appendicitis has shorter duration of hospital stay and the therapeutic time of antibiotics,improve the efficiency of clinical treatment,decrease the recurrence rate.but there is no significant difference in the incidence of treatment complications between appendectomy and appendectomy.Due to the limitations of the quality of the study,the above conclusions need to be verified by more high-quality studies.