Resumen

RODRIGUEZ FERNANDEZ, Zenén. Acute Appendicitis Management. Rev Cubana Cir [online]. 2019, vol.58, n.1  Epub 30-Jun-2019. ISSN 1561-2945.

The objective of this work is to study in depth the different cognitive aspects about the new evidences concerning the treatment of acute appendicitis and to compare the results obtained with the different surgical techniques currently used and the conservative treatment. A bibliographic review was carried out and articles were chosen from the electronic sources Web of Science, Scielo, Elsevier, PubMed, Medline, and Google, published in this century in Spanish and in English. Appendectomy by laparotomy has always been the "gold standard" for the treatment of acute appendicitis. In 1982, laparoscopic access was introduced, which has proven safe and efficient as conventional access. In 2004, endoscopic surgery through natural orifices was used; in 2007, it was performed by a single port, and in 2015, through retrograde endoscopy. The evolution of the clinical picture is variable so strategies have been proposed such as ambulatory surgery, conservative treatment followed or not by interval surgery, in order to avoid unnecessary interventions with morbidity and mortality similar to those performed with urgency. Appendectomy by laparotomy or laparoscopy is still the "golden standard" of the treatment of acute appendicitis, although laparoscopic access is required, new invasive techniques and outpatient surgery have emerged. Antibiotic therapy is essential and, as a single treatment, aims to reduce costs and morbidity associated with surgery; therefore, the adequate treatment of this disease is currently controversial and will depend on the established protocols of action, patient condition, and the available resources.

Palabras clave : acute appendicitis; surgical and nonsurgical treatment; Natural Orifice Transluminal Endoscopic Surgery (NOTES); Single Incisión Laparoscopic Surgery (SELS); Endoscopic retrograde appendicitis therapy (ERAT); outpatient surgery; interval surgery; morbidity; morality.

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