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from the now...on-to-the-tables-of-content dept.
After century of removing appendixes, docs find antibiotics can be enough:
After more than a century of slicing tiny, inflamed organs from people's guts, doctors have found that surgery may not be necessary after all—a simple course of antibiotics can be just as effective at treating appendicitis as going under the knife.
The revelation comes from a large, randomized trial out of Finland, published Tuesday, September 25, in JAMA.
Despite upending a long-held standard of care, the study's finding is not entirely surprising; it follows several other randomized trials over the years that had carved out evidence that antibiotics alone can treat an acute appendicitis. Those studies, however, left some dangling questions, including if the antibiotics just improved the situation temporarily and if initial drug treatments left patients worse off later if they did need surgery.
The new JAMA study, with its full, five-year follow-up, effectively cauterised those remaining issues. Nearly two-thirds of the patients randomly assigned in the study to get antibiotics for an uncomplicated appendicitis didn't end up needing surgery in the follow-up time, the Finnish authors, based at the University of Turku, report. And those drug-treated patients that did end up getting an appendectomy later were not worse off for the delay in surgery.
"This long-term follow-up supports the feasibility of antibiotic treatment alone as an alternative to surgery for uncomplicated acute appendicitis," the authors conclude.
The finding suggests that many appendicitis patients could be spared the risks of surgical procedures, such as infections. They may also be able to save money by not needing such an invasive procedure (although the study didn't compare costs), and they could reap the benefits of shorter treatment and recovery times. Researchers will have to collect more data to back up those benefits, though.
JAMA, 2018. DOI: 10.1001/jama.2018.13201
(Score: 2) by MichaelDavidCrawford on Thursday September 27 2018, @10:20PM (6 children)
Take it from someone who's had two surgeries:
To wake up in a recovery room feels just like Hannibal Lecter made supper out of one of your internal organs, with a side of Fava Beans and a nice Chianti.
Yes I Have No Bananas. [gofundme.com]
(Score: 0) by Anonymous Coward on Friday September 28 2018, @01:53AM (2 children)
I dunno. When I woke up from my surgery, I felt the best I ever have in my life.
(Score: 1, Offtopic) by Gaaark on Friday September 28 2018, @01:59AM (1 child)
Are you now a man or a woman?
--- Please remind me if I haven't been civil to you: I'm channeling MDC. ---Gaaark 2.0 ---
(Score: 0, Flamebait) by Acabatag on Friday September 28 2018, @02:13AM
Chromosomes never lie.
(Score: 1, Interesting) by Anonymous Coward on Friday September 28 2018, @02:55AM (1 child)
I've had five surgeries, three of which required general anesthesia. It's somewhat frightening, on looking back, to experience floating in a black void of barely being conscious and hearing the recovery room nurse yelling at you to remember to breathe... and after a while of thinking about the pros and cons, reluctantly deciding to start breathing again. All three surgeries.
Not sure I'd make the same choice if there's a fourth time...
(Score: 3, Funny) by Reziac on Friday September 28 2018, @03:26AM
That's why they turn you upsidedown and smack your sorry ass. :)
And there is no Alkibiades to come back and save us from ourselves.
(Score: 2, Interesting) by Anonymous Coward on Friday September 28 2018, @05:22AM
I had my appendix removed back in 1975, just south of my teenage years. After several years of mysterious intermittent pains, the thing finally went for the 'big one' early one afternoon and within hours I went under the knife, sure, they removed the inflamed appendix but fucked up the internal stitching as I discovered later that night in the hospital bed when I couldn't move and when the nurse finally came over and switched on the light beside the bed to find me lying a large pool of blood...bleeding out..so, once more unto the theatre dear friends...
This was back in the days of 'the bigger the opening, the better', It took that 3.5" scar several years to heal up properly, even then, there was an intermittent recurring infection at one of the suture points which finally went away in the early 80's.
And now, all that could have been avoided with just be a course of antibiotics, so, a bit of a win there, medical science (assuming the old 'law of unintended consequences' card doesn't get played).
I went back under the knife again last year (silly industrial accident required a bit to be amputated and a spot of reconstructive 3D jigsaw puzzlery performed on some shattered bone), I cannot fault the surgeons as they did a bloody good job with what they had to work with, but man, that general anaesthetic is scary shit, as a child back in '75 I'd no idea about the dangers of it, as an adult, however...I'm already aware of how close I am to that final /bin/rm -fr --no-preserve-root /, I could be doing without the chicken/dry runs at it..
(Btw, this time I was prepared for the chances of wound infections, I made sure I had a reasonable supply of iodopovidone at hand, which was just as well..)