Association Between Appendectomy And The Development Of Inflammatory Bowel Disease:a Meta-analysis

Objective Previous studies have shown positive and negative associations of appendectomy with Crohn’s disease (CD) and ulcerative colitis (UC), respectively. In order to examine the latest evidence on the effect of appendectomy on inflammatory bowel disease (IBD), we conducted a new meta-analysis to assess the risk of IBD following an appendectomy.Methods MEDLINE, Web of Science and Embase were used to search the studies evaluating the association between previous appendectomy and IBD. After screening, there were altogether32studies met our inclusion criteria, and then meta-analysis was performed to assess the studies.Results Altogether12047UC patients (351with appendectomy),7760CD patients (623with appendectomy) and48333UC controls (1777with appendectomy) and37467CD controls (1317with appendectomy) were identified in the32case-control studies. The overall odds ratios (ORs) for UC and CD vs. appendectomy were0.35(95%confidence interval (CI)=0.25-0.48, p-value<0.0001) and1.37(95%CI=0.93-2.01, p-value=0.1071), respectively. In the population under the age of20years old, the protective effect of appendectomy on UC was even prominent (OR=0.23,95%CI=0.16-0.35, p-value<0.0001). Again, appendectomy was not significantly associated with the risk of CD (OR=0.81,95%CI=0.37-1.78, p-value=0.60). Conclusion Our findings confirm the strong negative association between appendectomy and the development of UC, especially for those people under the age of20years old. However, appendectomy was not found to be significantly associated with CD.