Endoscopy 2021; 53(04): 424-428
DOI: 10.1055/a-1227-4555
Innovations and brief communications

Risk of appendicitis after endoscopic full-thickness resection of lesions involving the appendiceal orifice: a retrospective analysis

Simone Schmidbaur*
1  Universitätsklinik Ulm, Klinik für Innere Medizin I, Ulm, Germany
,
Andreas Wannhoff
2  Klinikum Ludwigsburg, Klinik für Innere Medizin, Gastroenterologie, Hämato-Onkologie, Pneumologie, Diabetologie und Infektiologie, Ludwigsburg, Germany
,
Benjamin Walter*
1  Universitätsklinik Ulm, Klinik für Innere Medizin I, Ulm, Germany
,
Benjamin Meier
2  Klinikum Ludwigsburg, Klinik für Innere Medizin, Gastroenterologie, Hämato-Onkologie, Pneumologie, Diabetologie und Infektiologie, Ludwigsburg, Germany
,
Claus Schäfer
3  Kliniken des Landkreises Neumarkt i.d. OPf., Neumarkt, Germany
,
Alexander Meining
4  Universitätsklinikum Würzburg, Medizinische Klinik und Poliklinik II, Gastroenterologie, Würzburg, Germany
,
Karel Caca
2  Klinikum Ludwigsburg, Klinik für Innere Medizin, Gastroenterologie, Hämato-Onkologie, Pneumologie, Diabetologie und Infektiologie, Ludwigsburg, Germany
› Author Affiliations

Abstract

Background Conventional endoscopic resection of lesions affecting the appendiceal orifice is difficult. Endoscopic full-thickness resection (EFTR) is a novel technique in interventional endoscopy. As EFTR near the appendiceal orifice is associated with a subtotal appendectomy, it remains unclear whether the risk of developing appendicitis is increased. We conducted a retrospective analysis of lesions involving the appendiceal orifice treated by EFTR.

Methods This was a multicenter retrospective analysis of patients (n = 50) treated with EFTR for lesions involving the appendiceal orifice between 2014 and 2019. The objective was to evaluate the occurrence of appendicitis.

Results Acute appendicitis occurred in seven patients (14 %) during follow-up. Conservative treatment was sufficient in four cases, and three patients underwent appendectomy.

Conclusions EFTR of lesions involving the appendiceal orifice may be associated with an imminent risk of developing appendicitis and a consecutive need for appendectomy. Patients should be informed about this specific risk prior to resection. It is unclear why some patients develop appendicitis while the majority remains asymptomatic.

* These authors contributed equally to this work.


Supplementary material



Publication History

Received: 23 November 2019

Accepted: 13 July 2020

Publication Date:
07 September 2020 (online)

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